From the Guidelines
Common side effects of Premgra (sildenafil) include headache, flushing, rhinitis, and dyspepsia, as well as less common effects like visual disturbances, myalgia, nausea, diarrhea, vomiting, dizziness, and chest pain 1. These side effects are typically mild to moderate and often resolve on their own as the medication is metabolized by the body. Some men may also experience back pain, muscle aches, or rash. Most side effects occur because sildenafil works by inhibiting phosphodiesterase type 5 (PDE5), which increases blood flow not only to the penis but also to other parts of the body. This mechanism explains the flushing and headaches that some users experience. More serious but rare side effects include priapism (prolonged erection lasting more than 4 hours), sudden vision or hearing loss, and cardiovascular events. If you experience any severe or persistent side effects, seek medical attention immediately. The likelihood of side effects may increase with higher doses, so it's essential to take only the prescribed amount and not exceed the recommended dosage of once per day. Key points to consider:
- High-quality evidence shows that men receiving PDE-5 inhibitors are more likely to have at least 1 adverse event compared with placebo recipients, but the incidence for more serious adverse events was less than 2%, with no difference between PDE-5 inhibitors and placebo 1.
- Sildenafil was associated with fewer adverse events than non–PDE-5 inhibitors and PDE-5 inhibitors combined with non–PDE-5 inhibitors 1.
- Very-low-quality evidence showed that adverse events did not statistically significantly differ among men receiving sildenafil, tadalafil, and vardenafil 1.
From the FDA Drug Label
The most common side effects with sildenafil tablets include: Nosebleed, headache, upset stomach, getting red or hot in the face (flushing), trouble sleeping, as well as fever, erection increased, respiratory infection, nausea, vomiting, bronchitis, pharyngitis, runny nose, and pneumonia in children. Other possible side effects of sildenafil tablets include: low blood pressure, more shortness of breath than usual, decreased eyesight or loss of sight in one or both eyes (NAION), sudden decrease or loss of hearing, heart attack, stroke, irregular heartbeats, and death, erections that last several hours.
Common side effects of Premgra (sildenafil) include:
- Nosebleed
- Headache
- Upset stomach
- Flushing
- Trouble sleeping
- Fever
- Erection increased
- Respiratory infection
- Nausea
- Vomiting
- Bronchitis
- Pharyngitis
- Runny nose
- Pneumonia in children Less common but serious side effects include:
- Low blood pressure
- Shortness of breath
- Decreased eyesight or loss of sight
- Sudden decrease or loss of hearing
- Heart attack
- Stroke
- Irregular heartbeats
- Death
- Erections that last several hours 2 2
From the Research
Common Side Effects of Premgra (Sildenafil)
- Headache
- Flushing
- Dyspepsia
- Abnormal vision
- Nasal congestion
- Back pain
- Myalgia
- Nausea
- Dizziness
- Rash 3
Serious Side Effects
- Severe hypotension and syncope when co-administered with nitrates or α-blockers 4
- Higher plasma concentrations when co-administered with cytochrome P (CYP) 3A inhibitors, which influences the side-effect profile 4