Silfil 50 mg Tablet

PDE5 inhibitor for:

• Erectile dysfunction in men (requires sexual stimulation to work)
• Pulmonary arterial hypertension (20 mg tablets, specialist use)

Erectile dysfunction: 50 mg about 1 hour before sexual activity (range 25–100 mg); maximum once in 24 hours. Start 25 mg in the elderly, liver/kidney impairment or with certain interacting drugs.

Pulmonary arterial hypertension: 20 mg three times daily (specialist).

• A heavy fatty meal may delay the effect.
• Not for women or men under 18 (for ED).

• Use with nitrates (glyceryl trinitrate, isosorbide) or nitric-oxide donors including "poppers" — dangerous fall in blood pressure
• Use with riociguat
• Men in whom sexual activity is inadvisable (severe heart disease, recent heart attack or stroke, unstable angina, severe heart failure)
• Very low blood pressure, severe liver impairment
• Loss of vision in one eye due to NAION, hereditary retinal disorders (retinitis pigmentosa)

Very common/common: headache, flushing, indigestion, nasal congestion, dizziness, visual changes (blue tinge, blurred vision, light sensitivity), back or muscle pain.

Less common: palpitations, fast heartbeat, nosebleed.

Rare but serious: erection lasting more than 4 hours (priapism) — seek emergency care; sudden loss of vision or hearing — stop and seek help; chest pain, heart attack, stroke, low blood pressure.

• Check heart fitness before sexual activity.
• Penile deformities, sickle cell disease, leukaemia, myeloma (priapism risk).
• Bleeding disorders or active peptic ulcer: use with caution.
• Avoid large amounts of alcohol.

Not indicated for women. For PAH in pregnancy only under specialist care.

• Nitrates and riociguat (contraindicated)
• Alpha-blockers (doxazosin, tamsulosin) — low blood pressure; start low dose
• Ritonavir (avoid), ketoconazole, itraconazole, erythromycin, clarithromycin (raise levels — use 25 mg)
• Other blood-pressure medicines and alcohol (more lowering)

Exaggerated side effects: headache, flushing, dizziness, visual changes, low blood pressure. Seek medical care.

Store below 30°C.