Viagra® (Sildenafil Citrate) 150mg – High-Potency ED Therapy
(Non-Standard Dose – Specialized Use Only)
⚠️ Critical Safety Advisory
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Exceeds FDA-Approved Maximum (100mg/day)
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Requires Urologist Supervision
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Not Commercially Manufactured
Theoretical Application
✔ Treatment-Resistant ED (After failed 100mg trials)
✔ Severe Vascular Insufficiency (Case-by-case basis)
✔ Short-Duration, High-Intensity Therapy
Heightened Risk Profile
🛑 Cardiovascular:
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Acute hypotension with nitrates
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Myocardial ischemia risk during activity
🛑 Prolonged Erections:
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4.7x higher priapism risk vs 50mg
🛑 Neurological:
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Severe headaches (23% incidence)
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Blue-tinted vision (dose-dependent)
Pharmacokinetics
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Onset: 30-45 minutes (fasting)
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Duration: 8-10 hour window
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Metabolism: Hepatic (CYP3A4)
Mandatory Safety Protocols
✅ Cardiac Clearance Required (Stress test if >40yo)
✅ Priapism Emergency Plan (Ice packs, ER contacts)
✅ Absolute Contraindications:
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Nitrate therapy
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Recent stroke/MI
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Retinitis pigmentosa
Clinically Preferred Alternatives
| Therapy | Dose | Advantage |
|---|---|---|
| Tadalafil Daily | 5mg | 24/7 readiness |
| Sildenafil 100mg + L-arginine | +2g | Enhanced efficacy |
| Vardenafil ODT | 10mg | Faster absorption |
Off-Label Use Requirements
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Documented failure of 100mg dose
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Signed informed consent
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Baseline ECG and BP monitoring
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Initial supervised trial dose
