CLINICAL USE

Treatment of erectile dysfunction

DOSE IN NORMAL RENAL FUNCTION

5–20 mg approximately 25–60 minutes before sexual activity

PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : 488.6
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : 95
  • %Excreted unchanged in urine &nbsp &nbsp : 2–6

  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp : 208 litres

  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp : 4–5

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

    Initial doses as for normal renal function, then maintenance doses of: 30–50 Dose as in normal renal function 10–30 Initial dose 5 mg and adjust accordingly
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Initial dose 5 mg and adjust accordingly

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp: Not dialysed. Dose as in GFR <10 mL/min. Use with caution

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : Not dialysed. Dose as in GFR <10 mL/min. Use with caution
  • HDF/high flux &nbsp : Unknown dialysability. Dose as in GFR <10 mL/min. Use with caution
  • CAV/VVHD &nbsp &nbsp &nbsp: Not dialysed. Dose as in GFR=10–30 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs Alpha-blockers: enhanced hypotensive effect – avoid for 6 hours after alpha- blockers (max dose 5 mg)
  • Antifungals: concentration increased by ketoconazole, and itraconazole – avoid concomitant use
  • Antivirals: concentration increased by amprenavir, indinavir, ritonavir, saquinavir – avoid with indinavir and ritonavir; reduce initial dose with saquinavir
  • Grapefruit juice: concentration possibly increased – avoid concomitant use Nicorandil: possibly enhanced hypotensive effect – avoid concomitant use
  • Nitrates: possibly enhanced hypotensive effect – avoid concomitant use

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

  • Contraindicated in dialysis patients due to lack of information, therefore suggest use with caution and monitor patients closely .
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