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Viagra: What else is Sildenafil used for besides ED?

Viagra: What else is Sildenafil used for besides ED?

Sildenafil citrate is best known as the active ingredient in the erectile dysfunction medication Viagra and its cheaper, generic cousin Sildenafil. It has helped countless men, brought visibility to a previously hush-hush condition and entered the public consciousness in a way few medications have. Even if you’ve never taken sildenafil, you likely know what it is. But did you know sildenafil has other uses as well?

Sildenafil is licensed for a few conditions — erectile dysfunction, pulmonary arterial hypertension (PAH), digital ulcers — and sometimes prescribed off-label for Raynaud’s phenomenon. But researchers are still learning what else this ingredient can do. There have been studies done to see if sildenafil can help with premature ejaculation, heart problems and even jet lag. Below, we’ll discuss current and explored uses of sildenafil, share a few interesting studies and help you figure out if this medication is right for you.

Daniel Atkinson
Medically reviewed by
Daniel Atkinson, GP Clinical Lead

“Sildenafil is licensed for a few conditions — erectile dysfunction, pulmonary arterial hypertension (PAH), digital ulcers — and sometimes prescribed off-label for Raynaud’s phenomenon. But researchers are still learning what else this ingredient can do.”

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Medically reviewed by
Dr Daniel Atkinson
GP Clinical Lead
on August 02, 2022.
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Other uses for Sildenafil

In the UK the only approved uses for sildenafil are the treatment of erectile dysfunction, pulmonary arterial hypertension and digital ulcers. The brand-name of the ED medication is, of course, Viagra. While the brand-name PAH medication is called Revatio.

Despite these similarities, though, the pills aren’t interchangeable because they contain different amounts of sildenafil and each requires their own prescription.

Sildenafil for pulmonary hypertension

Pulmonary hypertension is another way to say high blood pressure in the lungs. (It’s a bit fancier, but also a bit shorter.) And pulmonary arterial hypertension, or PAH, is a type of pulmonary hypertension where the pressure occurs in the arteries that go from your heart to your lungs. It’s not the same as regular high blood pressure and can be a life-threatening condition that ultimately leads to heart failure.

Enter the second brand-name version of sildenafil: Revatio. Revatio is a lower dose of sildenafil that’s taken multiple times a day, either orally or as an injection. When you have PAH, the arteries in your lungs are narrow or blocked, causing blood flow issues. This is bad for your lungs, because it raises the blood pressure there, and your heart, because it has to work extra hard to get enough blood to your lungs.

Sildenafil gets the blood pressure in your lungs back to a healthier level by relaxing the arteries, just like it helps blood flow to your penis when you have erectile dysfunction. It’s the same effect happening in a different area of the body.

What dose of sildenafil is used in PAH?

The amount of sildenafil in Revatio depends on whether you’re taking it as a pill, as an injection or solution. For the Revatio pill or suspension, 20mg is the recommended dose. Sildenafil 10mg and 2.5mg are recommended if you’re injecting Revatio — even though the injection doses are half the amount of the oral tablets, their effect on the body is the same. In both cases, you’ll take your PAH medication three times a day, 4-6 hours apart.

Explored uses for Sildenafil

Sildenafil’s story is far from over, and scientists are at work on discovering other uses for the medication. Here are a few of the conditions that sildenafil has been used to treat, as well as studies for potential future sildenafil uses.

Pulmonary arterial hypertension, another condition treated by sildenafil, is the name for a specific form of high blood pressure — one that occurs in the arteries of your lungs. But there’s a reason why Viagra is also linked with high blood pressure, even though it’s not licensed to treat it.

Inventing a medication takes a lot of trial and error. Sometimes, a pharmaceutical company will develop a treatment and discover that it doesn’t work… on that condition. This is what happened with sildenafil. When it was originally developed by Pfizer, sildenafil was supposed to treat high blood pressure (hypertension) and a type of chest pain called angina. During clinical trials, though, the researchers noticed that a lot of the test subjects were reporting erections as a side effect. The rest, as they say, is history.

There have been some studies done on patients with heart problems, but the results aren’t conclusive enough for another condition to be added to the list of things sildenafil can be prescribed for. With more studies, it’s possible this will change.

The reasoning behind taking Viagra for heart problems is the medication’s ability to dilate blood vessels. And there’s some evidence behind this theory. One study suggested sildenafil might be useful for patients with hypertension or pulmonary stenosis, and another that the use of PDE5 inhibitors (the class of drugs sildenafil and Viagra belong to) by men with coronary artery disease was “intriguing” but “insufficient to support any change in clinical practice.”

Although Viagra isn’t prescribed to treat premature ejaculation, several studies have shown promising results. One reported that sildenafil was “very effective and safe” — in fact, it was more effective than Paxil (paroxetine), an antidepressant occasionally prescribed off-label for PE. Another reported that sildenafil increased confidence and overall sexual satisfaction.

It’s possible that in the future, Viagra will be approved to treat premature ejaculation as well as ED. In the meantime, it can be a useful drug for someone experiencing both conditions.

Sildenafil cures jet lag — if you’re a hamster. Researchers at Quilmes National University in Argentina created an artificial “time change” using cage lights and observed when their normally nocturnal test subjects used their wheels. The resulting study, published in 2007, found that hamsters dosed with sildenafil recovered from jet lag up to 50% faster than the control group.

Think the only sketchy athletic performance enhancers used by athletes are steroids? Think again. Stories of athletes using the little blue pill to get a boost outside of the bedroom have been going around since at least 2006, when an American Physiological Society study tested Viagra on cyclists and found that it “significantly improved the cardiovascular and exercise performance measures of trained cyclists at high altitude.” (It didn’t help at all at sea level.)

In 2008, former Olympic physiologist Kenneth Rundell of Marywood University launched a clinical trial to see if sildenafil could help competitors get the edge while exercising in an area with high air pollution. And in 2012, multiple news outlets reported on NFL players taking Viagra before games.

Because Viagra improves blood flow, it’s possible that it could be helpful for athletes — especially those competing at high altitude. And, of course, it’s a lot harder to police “misuse” of bedroom pills like Viagra compared to steroids or amphetamines. This anecdotal evidence doesn’t mean you should abandon your pre-workout powder, though. Medication — particularly prescription medication — should not be used off-label without the support of your doctor.

How do I know if I need Viagra?

Although Viagra’s active ingredient sildenafil citrate is also used to treat pulmonary arterial hypertension, Viagra itself is only licensed for ED. The dose you’d use to treat PAH isn’t the same, and these medications can’t be used interchangeably. That goes for the generic Sildenafil with a capital ‘S’ as well. Even though the generic version of Viagra and the generic version of Revatio are both called Sildenafil, the dose is different and you need a separate prescription for each condition. So if you’re looking for help with pulmonary arterial hypertension or something other than ED, Viagra’s not the right medication for you. 

But if you’re experiencing erectile dysfunction, Viagra can help. It’s prescribed to treat ED with both physical and psychological causes, and is available in multiple strengths depending on your symptoms and medical history.

Viagra

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