Sildenafil, sold as the brand name Viagra among others, is a medication used to treat erectile dysfunction and pulmonary arterial hypertension. Common side effects include headaches and heartburn, as well as flushed skin. Caution is revatio prescribing information in those who have cardiovascular disease.
GMP, which regulates blood flow in the penis. Pfizer scientists Andrew Bell, David Brown, and Nicholas Terrett originally discovered sildenafil as a treatment for various cardiovascular disorders. Its use is now one of the standard treatments for erectile dysfunction, including for men with diabetes mellitus. Tentative evidence suggests that sildenafil may help men who experience antidepressant-induced erectile dysfunction. While sildenafil improves some markers of disease in people with pulmonary arterial hypertension, it does not appear to affect the risk of death or serious side effects as of 2014. Sildenafil has been studied for high-altitude pulmonary edema but its use is currently not recommended for that indication. Care should be exercised by people who are also taking protease inhibitors for the treatment of HIV infection. Protease inhibitors inhibit the metabolism of sildenafil, effectively multiplying the plasma levels of sildenafil, increasing the incidence and severity of side effects. Sildenafil’s popularity with young adults has increased over the years. Sildenafil’s trade name, Viagra, is widely recognized in popular culture, and the drug’s association with treating erectile dysfunction has led to its recreational use. Unprescribed recreational use of sildenafil and other PDE5 inhibitors is noted as particularly high among users of illegal drugs.
Sildenafil is sometimes used to counteract the effects of other substances, often illicit. The 2007 Ig Nobel Prize in Aviation went to Patricia V. Professional athletes have been documented using sildenafil, believing the opening of their blood vessels will enrich their muscles. In turn, they believe it will enhance their performances. Acetildenafil and other synthetic structural analogs of sildenafil which are PDE5 inhibitors have been found as adulterants in a number of “herbal” aphrodisiac products sold over-the-counter. The US FDA has banned numerous products claiming to be Eurycoma longifolia that, in fact, contain only analogs of sildenafil. N-desmethylsildenafil, its major active metabolite, may be quantified in plasma, serum, or whole blood to assess pharmacokinetic status in those receiving the drug therapeutically, to confirm the diagnosis in potential poisoning victims, or to assist in the forensic investigation in a case of fatal overdose. The major product of metabolisation by these enzymes is N-desmethylated sildenafil, which is metabolised further. Under the tongue use of sildenafil for erectile dysfunction results in an average onset of action of 15 minutes and lasting for an average of 40 minutes.
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There are also mouth spray preparations of sildenafil for faster onset of action. Pfizer’s Sandwich, Kent, research facility in England. The British press portrayed Peter Dunn and Albert Wood as the inventors of the drug, but only Andrew Bell, David Brown, and Nicholas Terrett are listed on the original composition of matter patent. In February 2007, it was announced that Boots, the UK pharmacy chain, would try over-the-counter sales of Viagra in stores in Manchester, England. On 6 May 2013, Pfizer, which manufactures Viagra, told the Associated Press they will begin selling the drug directly to patients on its website. US they were set to expire, but Pfizer settled litigation with each of Mylan and Teva which agreed that both companies could introduce generics in the US on 11 December 2017.
In December 2017, Pfizer released its own generic version of Viagra. Food and Drug Administration has approved 15 drug manufacturers to market generic sildenafil in the United States. Seven of these companies are based in India. This is likely to lead to dramatic price reductions. Viagra is one of the world’s most counterfeited medicines. Pfizer’s patent on sildenafil citrate expired in some member countries of the EU, Austria, Denmark, France, Germany, Ireland, Italy, The Netherlands, Spain, Sweden, the United Kingdom and Switzerland on 21 June 2013. There were 2,958,199 prescriptions for Sildenafil in 2016 in England, compared with 1,042,431 in 2006. In 2018, Viagra Connect, a particular formulation of Sildenafil marketed by Pfizer, became available for sale without a prescription in the UK , in an attempt to widen availability and reduce demand for counterfeit products. Sildenafil is available as a generic drug in the United States, labelled for pulmonary arterial hypertension. As of 2016 branded pills cost about 50 times more than generic ones.
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