Sildenafil Teva
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Understanding sildenafil contraindications and warnings is essential for safe treatment. The British National Formulary (BNF) outlines specific medications, conditions, and circumstances that require caution or complete avoidance when taking sildenafil. This guidance applies to both generic sildenafil and branded Viagra, helping patients make informed decisions about their ED treatment options.
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When PDE5 is suppressed, blood is able to flow more freely through the body—including to the (you guessed it) penis.

More blood flow to the penis means harder, more satisfying erections once you're sexually stimulated.
The BNF clearly states that sildenafil must never be taken with nitrate medications including GTN spray, isosorbide mononitrate, or isosorbide dinitrate. This combination can cause a dangerous drop in blood pressure that may be life-threatening. Riociguat, used for pulmonary hypertension, is also contraindicated with sildenafil treatment.
According to BNF guidelines, sildenafil should be avoided in men with severe heart disease, recent heart attack or stroke within six months, or very low blood pressure. Those with unstable angina or severe heart failure should not use sildenafil. A cardiovascular assessment is essential before starting treatment.
Alpha-blockers used for prostate problems or blood pressure may interact with sildenafil, potentially causing dizziness or fainting. The BNF recommends starting with lower doses if these medications cannot be avoided. Strong CYP3A4 inhibitors like ketoconazole or ritonavir may increase sildenafil levels, requiring dose adjustment.
Men with active peptic ulcers, bleeding disorders, or anatomical penile abnormalities need specialist evaluation before sildenafil use. Those with severe liver or kidney impairment may require dose reduction or alternative treatments. Vision problems, particularly NAION (non-arteritic anterior ischaemic optic neuropathy), warrant immediate medical attention.
The BNF advises limiting alcohol consumption as it may worsen erectile function and increase side effects like dizziness or headaches. Grapefruit juice should be avoided as it can affect how sildenafil is metabolised. Patients can choose between branded Viagra or generic sildenafil at EverydayMeds, with both options following the same BNF safety guidelines.
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