Patient leaflet - SILDENAFIL SANDOZ 25 MG ORODISPERSIBLE FILM
A SANDOZ
What Sildenafil is and what it is used for
Sildenafil belongs to a group of medicines called phosphodiesterase type 5 (PDE5) inhibitors. It works by helping to relax the blood vessels in your penis, allowing blood to flow into your penis when you get sexually excited. Sildenafil will only help you to get an erection if you are sexually stimulated.
Sildenafil is a treatment for adult men with erectile dysfunction, sometimes known as impotence. This is when a man cannot get, or keep a hard, erect penis suitable for sexual activity.
What you need to know before you take Sildenafil
Do not take Sildenafil if you
- are allergic to sildenafil or any of the other ingredients of this medicine (listed in section 6).
- are taking medicines called nitrates, as the combination may lead to a dangerous fall in your blood pressure. Tell your doctor if you are taking any of these medicines which are often given for relief of angina pectoris (or “chest pain”). If you are not certain, ask your doctor or pharmacist.
- are using any of the medicines known as nitric oxide donors such as amyl nitrite (“poppers”), as the combination may also lead to a dangerous fall in your blood pressure.
- are taking riociguat. This drug is used to treat pulmonary arterial hypertension (i.e., high blood pressure in the lungs) and chronic thromboembolic pulmonary hypertension (i.e., high blood pressure in the lungs secondary to blood clots). PDE5 inhibitors, such as Sildenafil have been shown to increase the hypotensive effects of this medicine. If you are taking riociguat or are unsure tell your doctor.
- have a severe heart or liver problem
- have recently had a stroke or a heart attack, or if you have low blood pressure
- have certain rare inherited eye diseases (such as retinitis pigmentosa)
- have ever had loss of vision due to non-arteritic anterior ischaemic optic neuropathy (NAION).
Warnings and precautions
Talk to your doctor before taking Sildenafil if you
- have sickle cell anaemia (an abnormality of red blood cells), leukaemia (cancer of blood cells), multiple myeloma (cancer of bone marrow).
- have a deformity of your penis or Peyronie’s Disease.
- have problems with your heart. Your doctor should carefully check whether your heart can take the additional strain of having sex
- currently have a stomach ulcer, or a bleeding problems (such as haemophilia)
- experience sudden decrease or loss of vision, stop taking Sildenafil and contact your doctor immediately.
You should not use Sildenafil with any other oral or local treatments for erectile dysfunction.
You should not use Sildenafil with treatments for pulmonary arterial hypertension (PAH) containing sildenafil or any other PDE5 inhibitors.
You should not take Sildenafil if you do not have erectile dysfunction.
You should not take Sildenafil if you are a woman.
Special considerations for patients with kidney or liver problems
You should tell your doctor if you have kidney or liver problems. Your doctor may decide on a lower dose for you.
Children and adolescents
Sildenafil should not be given to individuals under the age of 18.
Other medicines and Sildenafil
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
Sildenafil may interfere with some medicines, especially those used to treat chest pain. In the event of a medical emergency, you should tell your doctor that you have taken Sildenafil and when you did. Do not take Sildenafil with other medicines unless your doctor tells you that you can.
You should not take Sildenafil if you are taking medicines called nitrates, as the combination of these medicines may lead to a dangerous fall in your blood pressure. Always tell your doctor or pharmacist if you are taking any of these medicines that are often used for the relief of angina pectoris (or “chest pain”).
You should not take Sildenafil if you are using any of the medicines known as nitric oxide donors such as amyl nitrite (“poppers”) as the combination may also lead to a dangerous fall in your blood pressure.
Tell your doctor or pharmacist if you are already taking riociguat.
If you are taking medicines known as protease inhibitors, such as for the treatment of HIV, your doctor may start you on the lowest dose (25 mg) of Sildenafil.
Some patients who take alpha-blocker therapy for the treatment of high blood pressure or prostate enlargement may experience dizziness or light-headedness, which may be caused by low blood pressure upon sitting or standing up quickly. Certain patients have experienced these symptoms when taking Sildenafil with alpha-blockers. This is most likely to happen within 4 hours after taking Sildenafil. In order to reduce the chance that these symptoms might happen, you should be on a regular daily dose of your alpha-blocker before you start Sildenafil. Your doctor may start you on a lower dose (25 mg) of Sildenafil.
Sildenafil with food and drink and alcohol
Sildenafil can be taken with or without food. However, you may find that Sildenafil takes longer to start working if you take it with a heavy meal.
Drinking alcohol can temporarily impair your ability to get an erection. To get the maximum benefit from your medicine, you are advised not to drink excessive amounts of alcohol before taking Sildenafil.
Pregnancy, breast-feeding and fertility
Sildenafil is not indicated for use by women.
Driving and using machines
Sildenafil can cause dizziness and can affect vision. You should be aware of how you react to Sildenafil before you drive or use machinery.
How to take Sildenafil
Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.
The recommended starting dose is 50 mg.
You should not take Sildenafil more than once a day.
Do not take Sildenafil orodispersible films in combination with other sildenafil containing medicines.
You should take Sildenafil about one hour before you plan to have sex. Sildenafil orodispersible films are for oral use and are taken without water. If desired you may also take Sildenafil with water.
Instructions for use
Important: Do not handle the orodispersible film with wet hands!
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a) Take the sachet, locate the arrow mark at one of the shorter sides and hold the sachet with this side facing up.
The sachet is not sealed here.
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b) Gently peel both parts of the sachet apart at the arrow mark. Now you can hold each between your thumb and your index finger using one hand for each part.
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c) Carefully tear both parts of the sachet into opposite directions until they are separated. The orodispersible film is now visible and placed on one of the separated sachet parts.
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d) Take the orodispersible film with dry fingers out of the sachet and put it in your mouth directly on your tongue. It will dissolve rapidly, so that it can be easily swallowed.
If you feel that the effect of Sildenafil is too strong or too weak, talk to your doctor or pharmacist.
Sildenafil will only help you to get an erection if you are sexually stimulated. The amount of time Sildenafil takes to work varies from person to person, but it normally takes between half an hour and one hour. You may find that Sildenafil takes longer to work if you take it with a heavy meal.
If Sildenafil does not help you to get an erection or if your erection does not last long enough for you to complete sexual intercourse you should tell your doctor.
If you take more Sildenafil than you should
You may experience an increase in side effects and their severity. Doses above 100 mg do not increase the efficacy.
You should not take more orodispersible films than your doctor tells you to.
Contact your doctor if you take more orodispersible films than you should.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
Possible side effects
Like all medicines, this medicine can cause side effects although not everybody gets them. The side effects reported in association with the use of Sildenafil are usually mild to moderate and of a short duration.
If you experience any of the following serious side effects stop taking Sildenafil and seek medical help immediately:
- An allergic reaction – this occurs uncommonly (may affect up to 1 in 100 people)
Symptoms include sudden wheeziness, difficulty in breathing or dizziness, swelling of the eyelids, face, lips or throat.
- Chest pains – this occurs uncommonly If this occurs during or after intercourse – Get in a semi-sitting position and try to relax.
– Do not use nitrates to treat your chest pain.
- Prolonged and sometimes painful erections – this occurs rarely (may affect up to 1 in 1,000 people) If you have an erection which lasts for more than 4 hours, you should contact a doctor immediately.
- A sudden decrease or loss of vision – this occurs rarely
- Serious skin reactions – this occurs rarely Symptoms may include severe peeling and swelling of the skin, blistering of the mouth, genitals and around the eyes, fever.
- Seizures or fits – this occurs rarely
Other side effects:
Very common (may affect more than 1 in 10 people): headache.
Common (may affect up to 1 in 10 people): nausea, facial flushing, hot flush (symptoms include a sudden feeling of heat in your upper body), indigestion, colour tinge to vision, blurred vision, visual disturbance, stuffy nose and dizziness.
Uncommon (may affect up to 1 in 100 people): vomiting, skin rash, eye irritation, bloodshot eyes /red eyes, eye pain, seeing flashes of light, visual brightness, light sensitivity, watery eyes, pounding heartbeat, rapid heartbeat, high blood pressure, low blood pressure, muscle pain, feeling sleepy, reduced sense of touch, vertigo, ringing in the ears, dry mouth, blocked or stuffy sinuses, inflammation of the lining of the nose (symptoms include runny nose, sneezing and stuffy nose), upper abdominal pain, gastro-oesophageal reflux disease (symptoms include heartburn), presence of blood in urine, pain in the arms or legs, nosebleed, feeling hot and feeling tired.
Rare (may affect up to 1 in 1,000 people): fainting, stroke, heart attack, irregular heartbeat, temporary decreased blood flow to parts of the brain, feeling of tightening of the throat, numb mouth, bleeding at the back of the eye, double vision, reduced sharpness of vision, abnormal sensation in the eye, swelling of the eye or eyelid, small particles or spots in your vision, seeing halos around lights, dilation of the pupil of the eye, discolouration of the white of the eye, penile bleeding, presence of blood in semen, dry nose, swelling of the inside of the nose, feeling irritable and sudden decrease or loss of hearing.
From post-marketing experience cases of unstable angina (a heart condition) and sudden death have been reported rarely. Of note, most, but not all, of the men who experienced these side effects had heart problems before taking this medicine. It is not possible to determine whether these events were directly related to Sildenafil.
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the yellow card scheme (Website: ). By reporting side effects you can help provide more information on the safety of this medicine.
How to store Sildenafil
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the label and carton after EXP. The expiry date refers to the last day of that month.
Store in the original package. This medicine does not require any special temperature storage conditions.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
Contents of the pack and other information
What Sildenafil contains
- The active substance is sildenafil (as citrate).
Each orodispersible film contains 25 mg Sildenafil (as citrate).
Each orodispersible film contains 50mg Sildenafil (as citrate).
Each orodispersible film contains 75 mg Sildenafil (as citrate).
- The other ingredient(s) are: Hydroxypropylcellulose, glycerol 85%, sucralose, peppermint flavour (SYM 353592), levomenthol, sodium chloride, contramarum forte (SYM 225023), indigocarmin E132
What Sildenafil looks like and contents of the pack
This medicinal product is presented as orodispersible film.
Sildenafil 25 mg orodispersible film
The orodispersible film is a rectangular, flexible, light blue film strip (14 mm x 25 mm).
Sildenafil 50 mg orodispersible film
The orodispersible film is a rectangular, flexible, light blue film strip (28 mm x 25 mm).
Sildenafil 75 mg orodispersible film
The orodispersible film is a rectangular, flexible, light blue film strip (42 mm x 25 mm).
Each orodispersible film is packed in a PET/Alu/PE -Sachet.
Pack sizes of 1, 2, 4, 8, 10, 12, 16, 20, 24 or 28 orodispersible film(s).
Not all pack sizes may be marketed.
Marketing Authorisation Holder and Manufacturer
Sandoz Ltd,
Frimley Business Park, Frimley,
Camberley, Surrey, GU16 7SR, UK.
Manufacturers
HEXAL AG,
IndustriestraBe 25,
D-83607 Holzkirchen,
Germany
Salutas Pharma GmbH,
Otto-von-Guericke-Allee 1,
39179 Barleben,
Germany
LEK S.A.,
ul. Domaniewska 50 C,
02–672 Warszawa,
Poland
S.C. Sandoz, S.R.L.,
Str. Livezeni nr. 7A,
RO-540472 Targu-Mures,
Jud. Mures, Romania
Lek Pharmaceuticals d.d.,
Verovskova 57,
1526 Ljubljana,
Slovenia.
This leaflet was last revised in 04/2016.
00000000 SZ00000LT000
Artwork Proof Box
Ref: V006: Update to SPC&PIL to align with reference product
Proof no. Date prepared: Font size:
004.0 12/04/2016 7pt
Colours: Fonts:
■ Black □ Helvetica
Black 20% □
Dimensions: 130 × 350 mm