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DOSAGE AND ADMINISTRATION for VIAGRA® and CIALIS®

For most patients, the recommended dose for Viagra is 50 mg taken, as needed, approximately 1 hour before sexual activity. However, sildenafil citrate may be taken anywhere from 4 hours to 0.5 hour before sexual activity. Based on effectiveness and toleration, the dose may be increased to a maximum recommended dose of 100 mg or decreased to 25 mg.

Viagra should not be taken more than once a day. If you are older than 65 years, or have serious liver or kidney problems, your doctor may start you at the lowest dose (25 mg). If you are taking protease inhibitors, such as for the treatment of HIV, your doctor may recommend a 25 mg dose and may limit you to a maximum single dose of 25mg of Viagra in a 48-hour period.

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The recommended starting dose for Cialis® for most patients is 10 mg taken prior to anticipated sexual activity. A higher dose of 20mg is available for patients whose response to the 10mg dose is not adequate. A lower dose (5 mg) is also available and may be necessary for patients taking other medicines or having medical conditions that may decrease the body's ability to metabolize tadalafil. Cialis should not be used more than once per day.

Cialis should not be used with nitrates (such as nitroglycerin tablets or patches) or with an alpha blocker other than FLOMAX 0.4mg daily (alpha blockers are medicines used to treat benign prostatic hyperplasia and high blood pressure) because the combination may significantly lower blood pressure and lead to fainting or even death in some men.

Because some drugs affect the metabolism of Cialis, patients should inform their doctors that they are taking Cialis. For example, patients taking ketoconazole or ritonoavir should not take more than a 10mg dose of Cialis once every 72 hours.



The Following Factors are Associated with Increased Plasma Levels of Sildenafil:

Age >65 (40% increase in AUC), hepatic impairment (e.g., cirrhosis, 80%), severe renal impairment (creatinine clearance <30 ml/min, 100%), and concomitant use of potent cytochrome P450 3A4 inhibitors (erythromycin, ketoconazole, itraconazole, 200%, saquinavir 210%). Since higher plasma levels may increase both the efficacy and incidence of adverse events, a starting dose of 25 mg should be considered in these patients.

Given the extent of the interaction with patients receiving concomitant therapy with ritonavir, it is recommended not to exceed a maximum single dose of 25 mg of sildenafil citrate in a 48 hour period.

Sildenafil citrate was shown to potentiate the hypotensive effects of nitrates and its administration in patients who use nitric oxide donors or nitrates in any form is therefore contraindicated.

HOW SUPPLIED

Branded Viagra is supplied as blue, film-coated, rounded-diamond-shaped tablets containing sildenafil citrate equivalent to the nominally indicated amount of sildenafil as follows: 25 mg: Imprinted VGR25 on obverse side, PFIZER on reverse. 50 mg: Imprinted VGR50 on obverse side, PFIZER on reverse. 100 mg: Imprinted VGR100 on obverse side, PFIZER on reverse.

Generic forms of Sildenafil such as CAVERTA also come in 25mg, 50mg and 100mg doses though their appearances may vary.


Cialis will be available also as oral tablets in 10mg and 20mg strengths.

Recommended Storage: Store at controlled room temperature, 15-30°C (59-86°F)


 
 
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