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Writer's pictureTeresa Mendoza, PharmD

Med of the Week: Sildenafil



Sildenafil feature Viagra pill

Before you administer local anesthetics, nitrous oxide, NSAIDs, antibiotics, or other medications, check if your patient is taking Sildenafil (aka Viagra). Trust us, understanding these interactions isn’t hard—just keep reading!


Generic Name: Sildenafil

Brand Name(s): Viagra, Liqrev, Revatio

Pronunciation: sil DEN a fil


About this drug:

  • Sildenafil is used to treat erectile dysfunction (ED).

  • The brands, Liqrev and Revatio, are only indicated to treat pulmonary arterial hypertension.


Dentistry-related tidbits:

  • This medication may cause xerostomia. Consider prescribing a fluoride supplement to take and increase the frequency of dental exams.

  • Advise the patient to avoid consuming Alcohol to prevent severe hypotension.

  • Combining nitrates such as Nitrous Oxide, Nitroglycerin, or Isosorbide with Sildenafil may severely drop blood pressure and affect the patient's breathing.

  • Monitor blood pressure when administering Articaine, Bupivacaine, Lidocaine, Mepivacaine, or Ropivacaine to a patient taking Sildenafil since it may increase the risk of hypotension.

  • Exercise caution when prescribing narcotics, benzodiazepines, muscle relaxants, or any other sedating medication in combination with this medication to avoid an increased risk of hypotension, syncope, or diminished psychomotor function.

  • Speak with the patient's physician if the patient has severe hypotension, hypertension, tachycardia, palpitations, arrhythmias, or dyspnea before administering Epinephrine. 

  • Combining Sildenafil with aminoglycoside antibiotics (e.g. Gentamicin, Neomycin), the glycopeptide antibiotic Vancomycin, the antifungal Amphotericin, or certain NSAIDs (e.g. Fenoprofen, Naproxen, Salsalate) may increase the risk of auditory and vestibular side effects. Before prescribing any medication, use the Rx Check tool to prevent potential drug interactions or adverse effects.


Fun facts:

  • Sildenafil allows smooth muscle relaxation and inflow of blood to either the erectile tissue of the penis (only when there is sexual stimulation) or to the pulmonary vasculature.

  • This medication was originally intended to treat angina but it became a popular medication for erectile dysfunction.  

  • Sildenafil may cause the side effect of priapism, which is a painful or prolonged erection lasting longer than 4 hours that should receive medical attention.

  • Sildenafil should not be combined with Grapefruit as this combination may increase levels of Sildenafil and increase the risk of hypotension and priapism.


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