Use in adults
The recommended dose is 50 mg taken as needed approximately one hour before sexual activity. Based on efficacy and tolerability, the dose may be increased to 100 mg or decreased to 25 mg. The maximum recommended dose is 100 mg. The maximum recommended dosing frequency is once per day. If Viagra Capsules 25 mg is taken with food, the onset of activity may be delayed compared to the fasted state (see section 5.2).
Special populations
Elderly patients
Dosage adjustments are not required in elderly patients (? 65 years old).
Patients with renal impairment
The dosing recommendations described in “Use in adults” apply to patients with mild to moderate renal impairment (creatinine clearance = 30-80 mL/min).
Since Viagra Capsules 25 mg clearance is reduced in patients with severe renal impairment (creatinine clearance < 30 mL/min) a 25 mg dose should be considered. Based on efficacy and tolerability, the dose may be increased step-wise to 50mg up to 100 mg as necessary.
Patients with hepatic impairment
Since sildenafil clearance is reduced in patients with hepatic impairment (e.g. cirrhosis) a 25 mg dose should be considered. Based on efficacy and tolerability, the dose may be increased step-wise to 50 mg up to 100 mg as necessary.
Paediatric population
Viagra Capsules 25 mg is not indicated for individuals below 18 years of age.
Use in patients taking other medicinal products
With the exception of ritonavir for which co-administration with sildenafil is not advised (see Section 4.4) a starting dose of 25mg should be considered in patients receiving concomitant treatment with CYP3A4 inhibitors (see section 4.5).
In order to minimise the potential of developing postural hypotension in patients receiving alpha-blocker treatment patients should be stabilised on alpha-blocker therapy prior to initiating sildenafil treatment. In addition, initiation of sildenafil at a dose of 25mg should be considered (see sections 4.4 and 4.5).