Seeing blue after the little blue pill: visual disturbances in sildenafil users

If you have these symptoms, stop taking sildenafil tablets and contact a doctor right away. The most common side effects of sildenafil tablets are: abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision In addition, heart attack, stroke, irregular heartbeats and death have happened rarely in men taking sildenafil tablets.

Non-medical use

[4] Other drugs that interfere with the metabolism of sildenafil include erythromycin and cimetidine, both of which can also lead to prolonged plasma half-life levels. The use of sildenafil and an α1 blocker (typically prescribed for hypertension or for urologic conditions, such as benign prostatic hypertrophy) at the same time may lead to low blood pressure, but this effect does not occur if they are taken at least 4 hours apart. Concomitant use of nitric oxide donors, organic nitrites and nitrates,[30] such as: nitroglycerinisosorbide mononitrateisosorbide dinitratesodium nitroprussidealkyl nitrites (commonly known as "poppers") Concomitant use of soluble guanylyl cyclase stimulators, such as riociguat Sildenafil should not be used if sexual activity is inadvisable due to underlying cardiovascular risk factors. Sildenafil's popularity with young adults has increased over the years. [32] Sildenafil's brand name, Viagra, is widely recognized in popular culture, and the drug's association with treating erectile dysfunction has led to its recreational use.

Does sildenafil interact with foods or drinks?

[33] The reasons behind such use include the belief that the drug increases libido, improves sexual performance,[33] or permanently increases penis size. [34] Studies on the effects of sildenafil when used recreationally are limited, but suggest it has little effect when used by those who do not have erectile dysfunction. In one study, a 25 mg dose was shown to cause no significant change in erectile quality, but did reduce the postejaculatory refractory time. [35] This study also noted a significant placebo effect in the control group. Unprescribed recreational use of sildenafil and other PDE5 inhibitors is noted as particularly high among users of illegal drugs. It is not known if sildenafil tablets caused these problems. Store sildenafil tablets at room temperature between 68°F to 77°F (20°C to 25°C). Keep sildenafil tablets and all medicines out of the reach of children. PACKAGE LABEL.PRINCIPAL DISPLAY PANEL Sildenafil Citrate Tablets 25 mg - NDC 75834-272-30 - 30 Tablets LabelSildenafil Citrate Tablets 25 mg - NDC 75834-272-90 - 90 Tablets LabelSildenafil Citrate Tablets 25 mg - NDC 75834-272-00 - 1000 Tablets LabelSildenafil Citrate Tablets 50 mg - NDC 75834-240-30 - 30 Tablets LabelSildenafil Citrate Tablets 50 mg - NDC 75834-240-01 - 100 Tablets LabelSildenafil Citrate Tablets 50 mg - NDC 75834-240-05 - 500 Tablets LabelSildenafil Citrate Tablets 50 mg - NDC 75834-240-00 - 1000 Tablets LabelSildenafil Citrate Tablets 100 mg - NDC 75834-241-30 - 30 Tablets LabelSildenafil Citrate Tablets 100 mg - NDC 75834-241-01 - 100 Tablets LabelSildenafil Citrate Tablets 100 mg - NDC 75834-241-05 - 500 Tablets LabelSildenafil Citrate Tablets 100 mg - NDC 75834-241-00 - 1000 Tablets Label Sildenafil Citrate Tablets 25 mg - NDC 75834-272-30 - 30 Tablets Label Sildenafil Citrate Tablets 25 mg - NDC 75834-272-90 - 90 Tablets Label Sildenafil Citrate Tablets 25 mg - NDC 75834-272-00 - 1000 Tablets Label Sildenafil Citrate Tablets 50 mg - NDC 75834-240-30 - 30 Tablets Label Sildenafil Citrate Tablets 50 mg - NDC 75834-240-01 - 100 Tablets Label Sildenafil Citrate Tablets 50 mg - NDC 75834-240-05 - 500 Tablets Label Sildenafil Citrate Tablets 50 mg - NDC 75834-240-00 - 1000 Tablets Label Sildenafil Citrate Tablets 100 mg - NDC 75834-241-30 - 30 Tablets Label Sildenafil Citrate Tablets 100 mg - NDC 75834-241-01 - 100 Tablets Label Sildenafil Citrate Tablets 100 mg - NDC 75834-241-05 - 500 Tablets Label Sildenafil Citrate Tablets 100 mg - NDC 75834-241-00 - 1000 Tablets Label INGREDIENTS AND APPEARANCE Inactive IngredientsMAGNESIUM STEARATE (UNII: 70097M6I30)HYPROMELLOSES (UNII: 3NXW29V3WO)TITANIUM DIOXIDE (UNII: 15FIX9V2JP)LACTOSE MONOHYDRATE (UNII: EWQ57Q8I5X)TRIACETIN (UNII: XHX3C3X673)FD&C BLUE NO. 2 (UNII: L06K8R7DQK)Product CharacteristicsColorblueScoreno scoreShapeROUNDSize7mmFlavorImprint Code25;SLContainsPackagingNDC:75834-272-3030 in 1 BOTTLE; Type 0: Not a Combination Product06/16/2021NDC:75834-272-9090 in 1 BOTTLE; Type 0: Not a Combination Product06/16/2021NDC:75834-272-001000 in 1 BOTTLE; Type 0: Not a Combination Product06/16/2021Marketing InformationANDAANDA20930206/16/2021Labeler - NIVAGEN PHARMACEUTICALS, INC.

(052032418)EstablishmentUMEDICA LABORATORIES PRIVATE LIMITED920635096manufacture(75834-272, 75834-240, 75834-241) Sildenafil, sold under the brand name Viagra among others, is a medication used to treat erectile dysfunction and pulmonary arterial hypertension. [4][8] It is also sometimes used off-label for the treatment of certain symptoms in secondary Raynaud's phenomenon.

• The blue pill is part of a class of medications that include tadalafil and vardenafil.
• Each PDE5 inhibitor has different duration and onset times.
• Consult a doctor to choose the most appropriate medication.

[9] It is unclear if it is effective for treating sexual dysfunction in females. [8] It can be taken orally (swallowed by mouth), intravenously (injection into a vein), or through the sublingual route (dissolved under the tongue). [8][10] Onset when taken orally is typically within twenty minutes and lasts for about two hours. Common side effects include headaches, heartburn, and flushed skin. [8] Caution is advised in those with cardiovascular disease. [8] Rare but serious side effects include vision problems, hearing loss, and prolonged erection (priapism) that can lead to damage to the penis. [8] Sildenafil should not be taken by people on nitric oxide donors such as nitroglycerin, as this may result in a serious drop in blood pressure. Sildenafil acts by blocking phosphodiesterase 5 (PDE5), an enzyme that promotes breakdown of cGMP, which regulates blood flow in the penis. [8] It requires sexual arousal to work, and does not by itself cause or increase sexual arousal. [8] It also results in dilation of the blood vessels in the lungs.

other ED treatments

Pfizer originally discovered the medication in 1989 while looking for a treatment for angina. [11] It was approved for medical use in the United States and in the European Union in 1998. [5][8][11][12] In 2023, it was the 151st most commonly prescribed medication in the United States, with more than 3 million prescriptions. [13][14] It is available as a generic medication.

[15][16] In the United Kingdom, it is available as a pharmacy medicine. The primary indication of sildenafil is treatment of erectile dysfunction (inability to sustain a sildenafil 100g satisfactory erection to complete sexual intercourse). Its use is now one of the standard treatments for erectile dysfunction, including for males with diabetes mellitus. Tentative evidence suggests that sildenafil may help males 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. Sildenafil and other PDE5 inhibitors are used off-label to alleviate vasospasm and treat severe ischemia and ulcers in fingers and toes for people with secondary Raynaud's phenomenon;[9][21] these drugs have moderate efficacy for reducing the frequency and duration of vasospastic episodes. [9] As of 2016,[update] their role more generally in Raynaud's was not clear. Sildenafil has shown some potential for improving exercise performance at high altitudes. However, its overall efficacy is not clear. Sildenafil has been studied for high-altitude pulmonary edema (HAPE), but its use is currently not recommended for that indication.

2.4 Dosage Adjustments Due to Drug Interactions

If you have these symptoms, stop taking sildenafil tablets and contact a doctor right away. The most common side effects of sildenafil tablets are: abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision In addition, heart attack, stroke, irregular heartbeats and death have happened rarely in men taking sildenafil tablets. It is not known if sildenafil tablets caused these problems. Store sildenafil tablets at room temperature between 68°F to 77°F (20°C to 25°C). Keep sildenafil tablets and all medicines out of the reach of children.

Professional resources

PACKAGE LABEL.PRINCIPAL DISPLAY PANEL Sildenafil Citrate Tablets 25 mg - NDC 75834-272-30 - 30 Tablets LabelSildenafil Citrate Tablets 25 mg - NDC 75834-272-90 - 90 Tablets LabelSildenafil Citrate Tablets 25 mg - NDC 75834-272-00 - 1000 Tablets LabelSildenafil Citrate Tablets 50 mg - NDC 75834-240-30 - 30 Tablets LabelSildenafil Citrate Tablets 50 mg - NDC 75834-240-01 - 100 Tablets LabelSildenafil Citrate Tablets 50 mg - NDC 75834-240-05 - 500 Tablets LabelSildenafil Citrate Tablets 50 mg - NDC 75834-240-00 - 1000 Tablets LabelSildenafil Citrate Tablets 100 mg - NDC 75834-241-30 - 30 Tablets LabelSildenafil Citrate Tablets 100 mg - NDC 75834-241-01 - 100 Tablets LabelSildenafil Citrate Tablets 100 mg - NDC 75834-241-05 - 500 Tablets LabelSildenafil Citrate Tablets 100 mg - NDC 75834-241-00 - 1000 Tablets Label Sildenafil Citrate Tablets 25 mg - NDC 75834-272-30 - 30 Tablets Label Sildenafil Citrate Tablets 25 mg - NDC 75834-272-90 - 90 Tablets Label Sildenafil Citrate Tablets 25 mg - NDC 75834-272-00 - 1000 Tablets Label Sildenafil Citrate Tablets 50 mg - NDC 75834-240-30 - 30 Tablets Label Sildenafil Citrate Tablets 50 mg - NDC 75834-240-01 - 100 Tablets Label Sildenafil Citrate Tablets 50 mg - NDC 75834-240-05 - 500 Tablets Label Sildenafil Citrate Tablets 50 mg - NDC 75834-240-00 - 1000 Tablets Label Sildenafil Citrate Tablets 100 mg - NDC 75834-241-30 - 30 Tablets Label Sildenafil Citrate Tablets 100 mg - NDC 75834-241-01 - 100 Tablets Label Sildenafil Citrate Tablets 100 mg - NDC 75834-241-05 - 500 Tablets Label Sildenafil Citrate Tablets 100 mg - NDC 75834-241-00 - 1000 Tablets Label INGREDIENTS AND APPEARANCE Inactive IngredientsMAGNESIUM STEARATE (UNII: 70097M6I30)HYPROMELLOSES (UNII: 3NXW29V3WO)TITANIUM DIOXIDE (UNII: 15FIX9V2JP)LACTOSE MONOHYDRATE (UNII: EWQ57Q8I5X)TRIACETIN (UNII: XHX3C3X673)FD&C BLUE NO. 2 (UNII: L06K8R7DQK)Product CharacteristicsColorblueScoreno scoreShapeROUNDSize7mmFlavorImprint Code25;SLContainsPackagingNDC:75834-272-3030 in 1 BOTTLE; Type 0: Not a Combination Product06/16/2021NDC:75834-272-9090 in 1 BOTTLE; Type 0: Not a Combination Product06/16/2021NDC:75834-272-001000 in 1 BOTTLE; Type 0: Not a Combination Product06/16/2021Marketing InformationANDAANDA20930206/16/2021Labeler - NIVAGEN PHARMACEUTICALS, INC. (052032418)EstablishmentUMEDICA LABORATORIES PRIVATE LIMITED920635096manufacture(75834-272, 75834-240, 75834-241) Sildenafil, sold under the brand name Viagra among others, is a medication used to treat erectile dysfunction and pulmonary arterial hypertension. [4][8] It is also sometimes used off-label for the treatment of certain symptoms in secondary Raynaud's phenomenon. [9] It is unclear if it is effective for treating sexual dysfunction in females.

Incidence not known

[8] It can be taken orally (swallowed by mouth), intravenously (injection into a vein), or through the sublingual route (dissolved under the tongue). [8][10] Onset when taken orally is typically within twenty minutes and lasts for about two hours. Common side effects include headaches, heartburn, and flushed skin. [8] Caution is advised in those with cardiovascular disease. [8] Rare but serious side effects include vision problems, hearing loss, and prolonged erection (priapism) that can lead to damage to the penis. In clinical trials, the most common adverse effects of sildenafil use included headache, flushing, indigestion, nasal congestion, and impaired vision, including photophobia and blurred vision. [4] Some sildenafil users have complained of seeing everything tinted blue (cyanopsia). [24] This cyanopsia can be explained because sildenafil, while selective for PDE5, does have some affinity for PDE6, which is the phosphodiesterase found in the retina. Patients thus taking the drug sildenafil pink pill may experience colorvision abnormalities.

• Sildenafil 100mg can interact with certain medications, such as alpha-blockers, possibly leading to dangerous blood pressure drops.
• Patients with heart conditions should seek medical advice before use.
• Regular monitoring may be necessary for users with underlying health issues.

Some complained of blurriness and loss of peripheral vision. In July 2005, the US Food and Drug Administration (FDA) updated labeling for tadalafil (Cialis), vardenafil (Levitra), and sildenafil (Viagra) to reflect a small number of post-marketing reports of sudden vision loss, while acknowledging that "...it is not possible to determine whether these oral medicines for erectile dysfunction were the cause of the loss of eyesight or whether the problem is related to other factors such as high blood pressure or diabetes, or to a combination of these problems. "[25] A careful review of pooled data from clinical trials containing well documented information about the dose and duration of exposure to the drug for a large number of patients, yields no evidence for an increased risk of non-arteritic anterior ischemic optic neuropathy or other adverse ocular events associated with PDE5 inhibitor use. Rare but serious adverse effects found through postmarketing surveillance include prolonged erections, severe low blood pressure, myocardial infarction (heart attack), ventricular arrhythmias, stroke, increased intraocular pressure, and sudden hearing loss. [4] In October 2007, the FDA announced that the labeling for all PDE5 inhibitors, including sildenafil, required a more prominent warning of the potential risk of sudden hearing loss. 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. Those using protease inhibitors are recommended to limit their use of sildenafil to no more than one 25 mg dose every 48 hours.

Start your treatment journey

[8] Sildenafil should not be taken by people on nitric oxide donors such as nitroglycerin, as this may result in a serious drop in blood pressure. Sildenafil acts by blocking phosphodiesterase 5 (PDE5), an enzyme that promotes breakdown of cGMP, which regulates blood flow in the penis. [8] It requires sexual arousal to work, and does not by itself cause or increase sexual arousal. [8] It also results in dilation of the blood vessels in the lungs. Pfizer originally discovered the medication in 1989 while looking for a treatment for angina.

What should I know about sildenafil before taking it?

[11] It was approved for medical use in the United States and in the European Union in 1998. [5][8][11][12] In 2023, it was the 151st most commonly prescribed medication in the United States, with more than 3 million prescriptions. [13][14] It is available as a generic medication. [15][16] In the United Kingdom, it is available as a pharmacy medicine. The primary indication of sildenafil is treatment of erectile dysfunction (inability to sustain a sildenafil 100g satisfactory erection to complete sexual intercourse).

Altitude sickness

Its use is now one of the standard treatments for erectile dysfunction, including for males with diabetes mellitus. Tentative evidence suggests that sildenafil may help males 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. Sildenafil and other PDE5 inhibitors are used off-label to alleviate vasospasm and treat severe ischemia and ulcers in fingers and toes for people with secondary Raynaud's phenomenon;[9][21] these drugs have moderate efficacy for reducing the frequency and duration of vasospastic episodes. [9] As of 2016,[update] their role more generally in Raynaud's was not clear. [4] Other drugs that interfere with the metabolism of sildenafil include erythromycin and cimetidine, both of which can also lead to prolonged plasma half-life levels. The use of sildenafil and an α1 blocker (typically prescribed for hypertension or for urologic conditions, such as benign prostatic hypertrophy) at the same time may lead to low blood pressure, but this effect does not occur if they are taken at least 4 hours apart. Concomitant use of nitric oxide donors, organic nitrites and nitrates,[30] such as: nitroglycerinisosorbide mononitrateisosorbide dinitratesodium nitroprussidealkyl nitrites (commonly known as "poppers") Concomitant use of soluble guanylyl cyclase stimulators, such as riociguat Sildenafil should not be used if sexual activity is inadvisable due to underlying cardiovascular risk factors. Sildenafil's popularity with young adults has increased over the years. [32] Sildenafil's brand name, Viagra, is widely recognized in popular culture, and the drug's association with treating erectile dysfunction has led to its recreational use.

8.1 Pregnancy

Sildenafil has shown some potential for improving exercise performance at high altitudes. However, its overall efficacy is not clear. Sildenafil has been studied for high-altitude pulmonary edema (HAPE), but its use is currently not recommended for that indication. In clinical trials, the most common adverse effects of sildenafil use included headache, flushing, indigestion, nasal congestion, and impaired vision, including photophobia and blurred vision. [4] Some sildenafil users have complained of seeing everything tinted blue (cyanopsia).

How is sildenafil supplied (dosage forms)?

[24] This cyanopsia can be explained because sildenafil, while selective for PDE5, does have some affinity for PDE6, which is the phosphodiesterase found in the retina. Patients thus taking the drug sildenafil pink pill may experience colorvision abnormalities. Some complained of blurriness and loss of peripheral vision. In July 2005, the US Food and Drug Administration (FDA) updated labeling for tadalafil (Cialis), vardenafil (Levitra), and sildenafil (Viagra) to reflect a small number of post-marketing reports of sudden vision loss, while acknowledging that "...it is not possible to determine whether these oral medicines for erectile dysfunction were the cause of the loss of eyesight or whether the problem is related to other factors such as high blood pressure or diabetes, or to a combination of these problems. "[25] A careful review of pooled data from clinical trials containing well documented information about the dose and duration of exposure to the drug for a large number of patients, yields no evidence for an increased risk of non-arteritic anterior ischemic optic neuropathy or other adverse ocular events associated with PDE5 inhibitor use.

Raynaud's phenomenon

Rare but serious adverse effects found through postmarketing surveillance include prolonged erections, severe low blood pressure, myocardial infarction (heart attack), ventricular arrhythmias, stroke, increased intraocular pressure, and sudden hearing loss. [4] In October 2007, the FDA announced that the labeling for all PDE5 inhibitors, including sildenafil, required a more prominent warning of the potential risk of sudden hearing loss. 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. Those using protease inhibitors are recommended to limit their use of sildenafil to no more than one 25 mg dose every 48 hours. [33] The reasons behind such use include the belief that the drug increases libido, improves sexual performance,[33] or permanently increases penis size. [34] Studies on the effects of sildenafil when used recreationally are limited, but suggest it has little effect when used by those who do not have erectile dysfunction. In one study, a 25 mg dose was shown to cause no significant change in erectile quality, but did reduce the postejaculatory refractory time.

• Overuse or misuse of sildenafil can lead to adverse effects like priapism or cardiovascular issues.
• It is important to adhere strictly to prescribed dosages.
• Emergency medical attention is needed if painful erections occur.

[35] This study also noted a significant placebo effect in the control group. Unprescribed recreational use of sildenafil and other PDE5 inhibitors is noted as particularly high among users of illegal drugs.

7.5 Alcohol

[36] Sildenafil is sometimes used to counteract the effects of other substances, often illicit. [36] Sildenafil is sometimes used to counteract the effects of other substances, often illicit.