Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Sildenafil citrate
Drug ID BADD_D02019
Description In eliciting its mechanism of action, sildenafil ultimately prevents or minimizes the breakdown of cyclic guanosine monophosphate (cGMP) by inhibiting cGMP specific phosphodiesterase type 5 (PDE5) [F3850, F3853, F3856, F3859, F3883, F3886, L5611, L5614]. The result of doing so allows cGMP present in both the penis and pulmonary vasculature to elicit smooth muscle relaxation and vasodilation that subsequently facilitates relief in pulmonary arterial hypertension and the increased flow of blood into the spongy erectile tissue of the penis that consequently allows it to grow in size and become erect and rigid [F3850, F3853, F3856, F3859, F3883, F3886, L5611, L5614]. Interestingly enough, it is precisely via this mechanism why sildenafil was at first researched as a potential treatment for angina - or chest pain associated with inadequate blood flow to the heart - before being serendipitously indicated for treating erectile dysfunction in the late 1980s [A175732]. Nevertheless, it is because of this mechanism that sildenafil is also indicated for treating pulmonary arterial hypertension but is also additionally notorious for interacting with various anti-anginal or anti-hypertensive agents to develop potentially rapid, excessive, and/or fatal hypotensive crises [A175579, A175582, A175654]. Regardless, sildenafil, among a variety of other similar or related PDE5 inhibitors, has become a common and effective treatment for erectile dysfunction and since its formal approval for medical use in the public in 1998 [A175732], continues to see millions of prescriptions written for it internationally. Although the medication has historically been most popularly recognized as Pfizer's brand name Viagra, sildenafil is currently available generically and even as a non-prescription over the counter medication in some countries [L5656].
Indications and Usage For the treatment of erectile dysfunction and to relieve symptoms of pulmonary arterial hypertension (PAH).
Marketing Status Prescription; Discontinued
ATC Code G04BE03
DrugBank ID DB00203
KEGG ID D02229
MeSH ID D000068677
PubChem ID 135413523
TTD Drug ID Not Available
NDC Product Code 43353-345; 13668-185; 51927-5067; 67544-355; 72205-059; 71052-067; 67877-648; 50436-0033; 79572-031; 61281-1500; 59762-0036; 27808-163; 59762-0035; 62991-2556; 72375-0001; 67835-5042; 12658-0586; 0069-4220; 43063-256; 75834-241; 69097-903; 43353-764; 42185-7050; 59762-0034; 10695-017; 12658-0585; 50379-0001; 0395-8082; 67544-356; 69575-4002; 38779-2950; 50090-3905; 65015-861; 51552-1352; 75834-240; 72969-066; 55150-166; 0069-4190; 43063-550; 0069-0338; 75834-272; 68981-001; 0069-4210; 0069-4200; 49452-7528; 0069-0336; 50090-0619; 63275-9892; 65862-696; 51672-4231; 73377-082; 0904-6671; 62512-0038; 65977-0028; 47621-005; 65691-0063; 70954-168; 65015-652
Synonyms Sildenafil Citrate | Citrate, Sildenafil | 1-((3-(6,7-Dihydro-1-methyl-7-oxo-3-propyl-1H-pyrazolo(4,3-d)pyrimidin-5-yl)-4-ethoxyphenyl)sulfonyl)-4-methylpiperazine citrate | NCX-911 | NCX 911 | NCX911 | Revatio | Sildenafil | UK 92480-10 | UK 92480 10 | UK 9248010 | UK-92,480-10 | UK 92,480 10 | Homosildenafil | Hydroxyhomosildenafil | Viagra | Acetildenafil | Sildenafil Lactate | Lactate, Sildenafil | Sildenafil Nitrate | Nitrate, Sildenafil | Desmethyl Sildenafil | Sildenafil, Desmethyl | Desmethylsildenafil
Chemical Information
Molecular Formula C28H38N6O11S
CAS Registry Number 171599-83-0
SMILES CCCC1=NN(C2=C1N=C(NC2=O)C3=C(C=CC(=C3)S(=O)(=O)N4CCN(CC4)C)OCC)C.C(C(=O)O)C(CC(= O)O)(C(=O)O)O
Chemical Structure
ADR Related Proteins Induced by Drug
ADR Term Protein Name UniProt AC TTD Target ID PMID
Not AvailableNot AvailableNot AvailableNot AvailableNot Available
ADRs Induced by Drug
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Blindness17.17.01.003; 06.02.02.001--Not Available
Cardiovascular disorder24.03.02.009; 02.01.01.001--Not Available
Cerebral haemorrhage24.07.04.001; 17.08.01.003--Not Available
Cerebrovascular disorder24.03.05.002; 17.08.02.002--Not Available
Deafness04.02.01.001--Not Available
Death08.04.01.001--
Diarrhoea07.02.01.001--
Dyspepsia07.01.02.001--
Dyspnoea22.02.01.004; 02.01.03.002--
Epistaxis24.07.01.005; 22.04.03.001--
Erythema23.03.06.001--Not Available
Eye haemorrhage24.07.05.002; 06.07.02.001--Not Available
Flushing24.03.01.002; 23.06.05.003; 08.01.03.025--
Gastritis07.08.02.001--
Headache17.14.01.001--
Hypertension24.08.02.001--
Hypotension24.06.03.002--
Insomnia19.02.01.002; 17.15.03.002--
Myalgia15.05.02.001--
Myocardial infarction02.02.02.007; 24.04.04.009--
Nasal congestion22.04.04.001--
Nausea07.01.07.001--
Oedema14.05.06.010; 08.01.07.006--Not Available
Oedema peripheral14.05.06.011; 08.01.07.007; 02.05.04.007--
Pain in extremity15.03.04.010--
Paraesthesia17.02.06.005--
Priapism21.03.01.005--Not Available
Pulmonary haemorrhage24.07.01.016; 22.02.04.003--
Pyrexia08.05.02.003--
Retinal haemorrhage24.07.05.003; 06.10.01.001--Not Available
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