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Vybrique
sildenafil
Adult Dosing .
Dosage forms: STRIP: 25 mg, 50 mg, 75 mg, 100 mg
erectile dysfunction
- [25-100 mg PO x1]
- Start: 50 mg PO x1; Max: 100 mg/dose up to 1 dose/day; Info: give approximately 1h before sexual activity; do not cut/chew strip; start 25 mg PO x1 in patients >65 yo
renal dosing
- [adjust dose amount]
- CrCl <30: start 25 mg x1
- HD/PD: not defined
hepatic dosing
- [adjust dose amount]
- hepatic impairment: start 25 mg x1
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- pulmonary veno-occlusive disease (pulmonary HTN use)
- caution: patients 50 yo and older
- caution: smokers
- caution: CrCl <30 (erectile dysfunction use)
- caution: hepatic impairment (erectile dysfunction use)
- caution: HTN
- caution: BP <90/50
- caution: hypovolemia
- caution: LV outflow obstruction
- caution: autonomic dysfunction
- caution: heart failure (erectile dysfunction use)
- caution: MI within 6mo (erectile dysfunction use)
- caution: stroke within 6mo (erectile dysfunction use)
- caution: life-threatening arrhythmia within 6mo (erectile dysfunction use)
- caution: CAD
- caution: diabetes mellitus
- caution: hyperlipidemia
- caution: anterior ischemic optic neuropathy history, non-arteritic
- caution: optic cup-to-disc ratio, low
- caution: retinal disorder, hereditary degenerative
- caution: penile deformity
- caution: priapism risk
- caution: sickle cell disease
- caution: bleeding risk
Drug Interactions .
Overview
sildenafil
PDE5 inhibitor
- CYP3A4 substrate
- ototoxicity
- vasodilator agent
Contraindicated
- atazanavir
- cobicistat
- darunavir
- fosamprenavir
- isosorbide dinitrate
- isosorbide mononitrate
- lopinavir/ritonavir
- nelfinavir
- nitroglycerin
- nitroprusside
- riociguat
- ritonavir
- tipranavir
- vericiguat
Avoid/Use Alternative
- adagrasib
- aldesleukin
- amikacin
- amikacin inhaled
- avanafil
- captopril
- ceritinib
- chloramphenicol
- clarithromycin
- erythromycin
- ethacrynic acid
- gentamicin
- idelalisib
- itraconazole
- ketoconazole
- levoketoconazole
- lofexidine
- lonafarnib
- mifepristone
- nefazodone
- neomycin
- plazomicin
- posaconazole
- relacorilant
- ribociclib
- sildenafil
- streptomycin
- tadalafil
- tobramycin
- tobramycin inhaled
- tucatinib
- vardenafil
- voriconazole
Monitor/Modify Tx
- acebutolol
- alfentanil
- alfuzosin
- aliskiren
- alprostadil intracavernous
- amantadine
- amifostine
- amiloride
- amitriptyline
- amlodipine
- amoxapine
- apalutamide
- apomorphine
- apraclonidine ophthalmic
- aprepitant
- aprocitentan
- aripiprazole bimonthly injection
- aripiprazole lauroxil
- aripiprazole monthly injection
- aripiprazole oral
- articaine
- asenapine
- atenolol
- avacopan
- azilsartan medoxomil
- benazepril
- berberine
- berotralstat
- betaxolol
- betaxolol ophthalmic
- bethanechol
- bexagliflozin
- bisoprolol
- bortezomib
- bosentan
- brexpiprazole
- brimonidine ophthalmic
- brimonidine topical
- bromocriptine
- bumetanide
- bupivacaine
- bupivacaine liposomal
- buprenorphine
- butalbital
- butorphanol
- cabergoline
- canagliflozin
- candesartan cilexetil
- cannabis
- carbamazepine
- cariprazine
- carteolol ophthalmic
- carvedilol
- cenobamate
- chloroprocaine
- chlorothiazide
- chlorpromazine
- chlorthalidone
- cilostazol
- ciprofloxacin
- cisplatin
- clevidipine
- clofarabine
- clofazimine
- clomipramine
- clonidine
- clozapine
- codeine
- coenzyme Q-10
- conivaptan
- crizotinib
- cyclosporine
- dabrafenib
- danazol
- dapagliflozin
- deferasirox
- deferoxamine
- denileukin diftitox
- desflurane
- desipramine
- dexmedetomidine
- dexmedetomidine injection
- dihydrocodeine
- diltiazem
- dinutuximab
- dipyridamole
- doxazosin
- doxepin
- dronabinol
- dronedarone
- duloxetine
- duvelisib
- efavirenz
- eflornithine
- elagolix
- empagliflozin
- enalapril
- enalaprilat
- encorafenib
- entacapone
- entrectinib
- enzalutamide
- eplerenone
- epoprostenol
- ertugliflozin
- esmolol
- ethanol (alcoholic beverage)
- ethanol injection
- etravirine
- etripamil nasal
- fedratinib
- felodipine
- fenoldopam
- fentanyl
- ferumoxytol
- fexinidazole
- flaxseed
- flibanserin
- fluconazole
- fluphenazine
- fosinopril
- foslevodopa
- fosphenytoin
- furosemide
- garlic
- gilteritinib
- grapefruit
- guanfacine
- haloperidol
- hydralazine
- hydrochlorothiazide
- hydrocodone
- hydromorphone
- iloperidone
- iloprost
- imatinib
- imipramine
- indapamide
- irbesartan
- iron sucrose
- isavuconazonium
- isocarboxazid
- isoflurane
- isradipine
- ivosidenib
- labetalol
- landiolol
- lefamulin
- lenacapavir
- letermovir
- levobunolol ophthalmic
- levodopa
- levorphanol
- lidocaine
- lisinopril
- lorlatinib
- losartan
- loxapine
- lubiprostone
- lumacaftor/ivacaftor
- lumateperone
- lurasidone
- magnesium sulfate
- maraviroc
- mavacamten
- meperidine
- mepivacaine
- methadone
- methohexital
- methyldopa
- methylene blue injection
- metolazone
- metoprolol
- midazolam
- milrinone
- milsaperidone
- minoxidil
- mirtazapine
- mitapivat
- mitotane
- modafinil
- moexipril
- molindone
- morphine
- nadolol
- nafcillin
- nalbuphine
- nattokinase
- naxitamab
- nebivolol
- netupitant
- niacin (vitamin B3)
- nicardipine
- nifedipine
- nilotinib
- nimodipine
- nirogacestat
- nisoldipine
- nitric oxide
- nitrite
- nortriptyline
- obinutuzumab
- olanzapine
- oliceridine
- olmesartan medoxomil
- opicapone
- opium
- oxaliplatin
- oxazepam
- oxycodone
- oxymorphone
- pacritinib
- paliperidone
- palopegteriparatide
- paromomycin
- pentamidine
- pentazocine
- pentobarbital
- perindopril
- perphenazine
- pexidartinib
- phenelzine
- phenobarbital
- phenoxybenzamine
- phentolamine
- phenylephrine injection
- phenytoin
- pindolol
- pramipexole
- prazosin
- primidone
- procarbazine
- prochlorperazine
- promethazine
- propafenone
- propofol
- propranolol
- protriptyline
- quetiapine
- quinapril
- ramipril
- rasagiline
- remifentanil
- remimazolam
- repotrectinib
- rifabutin
- rifampin
- rifapentine
- rilzabrutinib
- risperidone
- ropinirole
- ropivacaine
- rotigotine transdermal
- sacubitril
- safinamide
- sapropterin
- selegiline
- selegiline transdermal
- sepiapterin
- sevoflurane
- silodosin
- sodium ferric gluconate complex
- sotagliflozin
- sotalol
- sotorasib
- sparsentan
- spironolactone
- St. John's wort
- sufentanil
- tagraxofusp
- tamsulosin
- tapentadol
- taurine
- telmisartan
- teprotumumab
- terazosin
- thalidomide
- thioridazine
- thiothixene
- timolol
- timolol ophthalmic
- tizanidine
- tolcapone
- torsemide
- tramadol
- trandolapril
- tranylcypromine
- trazodone
- treprostinil
- triamterene
- trifluoperazine
- trimipramine
- valsartan
- vancomycin
- verapamil
- vosoritide
- yohimbe
- ziprasidone
Caution Advised
- amphotericin
- carboplatin
- chloroquine
- docetaxel
- fenoprofen
- fludarabine
- isotretinoin
- naproxen
- neomycin otic
- quinidine (antiarrhythmic)
- quinidine (CYP2D6 inhibitor)
- quinine
- salsalate
- verteporfin
- vinblastine
- vincristine
- vinorelbine
Adverse Reactions .
Serious Reactions
- hypersensitivity reaction
- anaphylaxis
- sudden death (erectile dysfunction use)
- MI (erectile dysfunction use)
- ventricular arrhythmia (erectile dysfunction use)
- hypotension, severe
- seizures
- ischemic stroke (erectile dysfunction use)
- hemorrhagic stroke (erectile dysfunction use)
- pulmonary hemorrhage (erectile dysfunction use)
- retinal hemorrhage
- non-arteritic anterior ischemic optic neuropathy
- vision loss
- hearing loss
- priapism
- vaso-occlusive crisis (pulmonary HTN use)
Common Reactions
- headache
- flushing
- dyspepsia
- limb pain
- epistaxis
- diarrhea (pulmonary HTN use)
- nasal congestion
- insomnia
- myalgia
- back pain
- dyspnea
- visual disturbance
- erection (pulmonary HTN use in peds patients)
- erythema
- fever (pulmonary HTN use)
- rhinitis
- dizziness
- sinusitis
- gastritis
- paresthesia
- rash
- nausea
Safety/Monitoring .
Monitoring Parameters
Cr at baseline
Look/Sound-Alike Drug Names
sildenafil confused with: tadalafil; vardenafil
Pregnancy/Lactation .
Pregnancy
Clinical Summary
N/A; drug unlikely to be used during pregnancy based on indication
Lactation
Clinical Summary
N/A; drug unlikely to be used while breastfeeding based on indication
Pharmacology .
Metabolism: for sildenafil: liver; CYP450: 2C9, 3A4 (primary) substrate; Info: active metabolite
Excretion: for sildenafil: feces 80%, urine 13%; Half-life: 4h
Subclass: Erectile Dysfunction ; Sexual Dysfunction
Mechanism of Action
for sildenafil: inhibits phosphodiesterase type 5, enhancing effects of nitric oxide-activated increases in cGMP
Formulary .
No Formulary Selected
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