2024年5月5日发(作者：oppofindx3为什么降价这么快)

Sildenafil citrate, sold as Viagra, Revatio and under various other trade names, is a drug used to

treat erectile dysfunction and pulmonary arterial hypertension (PAH). It was originally developed

by British scientists and then brought to market by the US-based pharmaceutical company Pfizer.

It acts by inhibiting cGMP-specific phosphodiesterase type 5, an enzyme that promotes

degradation of cGMP, which regulates blood flow in the penis. Since becoming available in 1998,

sildenafil has been the prime treatment for erectile dysfunction; its primary competitors on the

market are tadalafil (Cialis) and vardenafil (Levitra).visit more in

枸橼酸西地那非（Sildenafil citrate）又名昔多芬，一氧化氮样药物。商品名有Viagra（万艾

可/伟哥）、Revatio（瑞肺得）等。是用于治疗ED（男性勃起障碍/阳痿）和PAH（

肺动脉高

压）的药物。它首先是英国科学家发明，由美国辉瑞（Pfizer）制药公司推向市场的。

西地那非是一

种PDE5抑制剂（cGMP-specific phosphodiesterase type 5，5型磷酸二酯酶抑制剂）。

通过抑制

降解cGMP的5型磷酸二酯酶活性而增高细胞内cGMP浓度，导致平滑肌松弛，使阴茎海绵体内动

脉血流增加，产生勃起。自1998年上市后，

西地那非成为治疗ED的首选药物。其他的竞争药

物有他达拉非tadalafil（Cialis，希力士）和伐地那非vardenafil（Levitra，艾力达）。

Medical uses

药物作用

Sexual dysfunction

性功能障碍

The primary indication of sildenafil is treatment of erectile dysfunction (inability to sustain a

satisfactory erection to complete intercourse). Its use is now standard treatment for erectile

dysfunction in all settings, including diabetes.

西地那非是治疗阳痿（无法保持满意的勃起状态而无法完成性交活动）的首选药物。如今它

是治疗由各种疾病，包括糖尿病导致ED（阳痿）的标准药物。

People on antidepressants may experience sexual dysfunction, either as a result of their illness or

as a result of their treatment. A 2003 study showed that sildenafil improved sexual function in

men in this situation. Following up reports from 1999, the same researchers found that sildenafil

improved sexual function in female patients on antidepressants as well.

服用抗抑郁剂可能导致勃起障碍，不过抑郁症也会引起ED。2003年的一项研究表明，西地

那非能够改善男性的勃起障碍。值得一提的是，该项研究的研究者们早在1999年就发现，

西地那非能够提高服用抗抑郁药的女性患者的性欲。

Pulmonary hypertension

肺动脉高压

As well as erectile dysfunction, sildenafil citrate is also effective in the rare disease pulmonary

arterial hypertension (PAH). It relaxes the arterial wall, leading to decreased pulmonary arterial

resistance and pressure. This, in turn, reduces the workload of the right ventricle of the heart and

improves symptoms of right-sided heart failure. Because PDE-5 is primarily distributed within the

arterial wall smooth muscle of the lungs and penis, sildenafil acts selectively in both these areas

without inducing vasodilation in other areas of the body. Pfizer submitted an additional

registration for sildenafil to the FDA, and sildenafil was approved for this indication in June 2005.

The preparation is named Revatio, to avoid confusion with Viagra, and the 20 milligram tablets

are white and round. Sildenafil joins bosentan and prostacyclin-based therapies for this

condition.

西地那非还用于治疗罕见的肺动脉高压。它可以扩张动脉血管，降低肺动脉的抵抗力和压力，从而减

轻右心室的工作负荷和改善右心力衰竭（right-sided heart failure）。因为

PDE-5（

5型磷酸二酯酶）

主要分布于肺部动脉平滑肌和阴茎。西地那非选择性地作用于这些区域，而不会引起身体其

他区域的血管舒张。2005年6月，美国FDA批准一种西地那非制剂用于治疗

肺动脉高压，为

避免和

Viagra（

万艾可）混淆，其商品名为

Revatio（瑞肺得），且剂量为20mg的白色圆状片

剂

。（译者注：万艾可为

蓝色薄膜包衣的圆棱形

片剂，剂量有25、50、100mg三种）。西地那非常

联合波生坦（bosentan）和前列环素

类药物治疗PAH。

Altitude sickness

高空病/高原病

Sildenafil has been shown to be useful for the prevention and treatment of high-altitude

pulmonary edema associated with altitude sickness such as that suffered by mountain climbers.

While this effect has only recently been discovered, sildenafil is already becoming an accepted

treatment for this condition, in particular in situations where the standard treatment of rapid

descent has been delayed for some reason.

由于在高空中空气稀薄导致血液及组织缺氧所产生的反应（如头痛、倦怠、心悸、鼻出血、恶心）。

西地那非已经证明可以预防和治疗高空肺水肿。

Dosage

给药剂量

Viagra pills are blue and diamond-shaped with the word "Pfizer" engraved on one side, and "VGR

xx" (where xx stands for "25", "50" or "100", the dose of that pill in milligrams) engraved on the

other. It is not taken more than once per day between 30 minutes and 4 hours prior to sexual

intercourse.

万艾可/伟哥是一种蓝色薄膜包衣的圆棱形

片剂，一面刻有“Pfizer”字样，另一面为“VGR xx”

（XX有3种，分别为25、50、100，单位为mg）。一天最多只能服用1次，性爱活动前30分钟～4

小时口服。

The dosage for pulmonary arterial hypertension (Revatio) is three times a day. Revatio pills are

white, round, film-coated tablets imprinted with "RVT 20" embossed on one side.

Revatio（瑞肺得）是一种白色薄膜包衣的圆状片剂。“RVT 20”字样则凸出药片的表面。用

法为一天3次。

Adverse effects

副作用

In clinical trials, the most common adverse effects of sildenafil use included headache, flushing,

dyspepsia, nasal congestion and impaired vision, including photophobia and blurred

sildenafil users have complained of seeing everything tinted blue (cyanopsia).Some complained

of blurriness and loss of peripheral vision. In July 2005, the U.S. Food and Drug Administration

found that sildenafil could lead to vision impairment in rare cases and a number of studies have

linked sildenafil use with nonarteritic anterior ischemic optic neuropathy.

临床试验中，最常见的副作用有头疼、脸红、消化不良、鼻充血和视觉异常，包括畏光和视

物模糊。一些服用者会出现蓝视（即看到东西带有蓝色的色彩）、视觉模糊或周边视觉的现

象。2005年7月，美国FDA发现西地那非罕见的副作用——视力损伤，另外若干研究表明

使用西地那非和前部缺血性视神经病有着相关性。

Rare but serious adverse effects found through postmarketing surveillance include priapism,

severe hypotension, myocardial infarction (heart attack), ventricular arrhythmias, stroke,

increased intraocular pressure, and sudden hearing loss. As a result of these postmarketing

reports, in October 2007, the FDA announced that the labeling for all PDE5 inhibitors, including

sildenafil, required a more prominent warning of the potential risk of sudden hearing loss.

通过药物售后监察发现罕见且严重的副作用有阴茎持续勃起、严重低血压、心肌梗死、室性

心律失常、中风、眼内压增高和突发性耳聋。2007年10月，FDA要求所有的PDE5抑制剂，

包括西地那非需标记可能会导致潜在突发性耳聋的风险。

Interactions

药物的相互作用

Care should be exercised by patients that are also taking protease inhibitors for the treatment of

HIV. Protease inhibitors inhibit the metabolism of sildenafil, effectively multiplying the plasma

levels of sildenafil, increasing the incidence and severity of side effects. It is recommended that

patients using protease inhibitors limit their use of sildenafil to no more than one 25 mg dose

every 48 hours. Other drugs that interfere with the metabolism of sildenafil include erythromycin

and cimetidine, both of which can also lead to prolonged plasma half life levels.

Concomitant use of sildenafil and an alpha blocker may lead to low blood pressure, but this effect

does not occur if they are taken at least four hours apart.

服用蛋白酶抑制剂（

Protease inhibitors）

治疗HIV的患者需要特别的注意。蛋白酶抑制剂会抑

制西地那非的新陈代谢，增加血浆水平结合率，可能造成以外和严重的副反应。故药物专家

推荐48小时内最多只能服用25mg。其他会干扰西地那非代谢的药物有甲氰咪胺（cimetidine，

胃黏膜保护药）、红霉素（erythromycin）会增加血浆半衰期（plasma half-life）水平。

西地那非和

α受体阻断药物一起使用可能造成血压过低。不过两者间隔4个小时服用则不会

发生。

Contraindications

禁忌症

Contraindications include: When taking nitric oxide donors, organic nitrites and nitrates, such as

glyceryl trinitrate (nitroglycerin), sodium nitroprusside, amyl nitrite ("poppers")

服用任何硝酸盐类药物。如硝酸甘油、硝普钠、亚硝酸戊酯等

In men for whom sexual intercourse is inadvisable due to cardiovascular risk factors

身体条件不适宜过性生活，如严重的心脏病

Severe hepatic impairment (decreased liver function)

严重的肝损伤（肝功能不足）

Severe impairment in renal function

严重的肾损伤（肾功能不足）

Hypotension (low blood pressure)

低血压

Recent stroke or heart attack

最近发生过中风或心脏病

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Hereditary egenerative retinal disorders,including genetic disorders of retinal phosphodiesterases

遗传性视网膜退化症（包括遗传性视黄醛磷酸二酯酶失调）