Uses

Erectile Dysfunction (ED)

ED is the main, on-label indication for which Caverta 100 mg is prescribed. In ED, Caverta 100 mg works by promoting vasodilation (increased diameter of blood vessels), improved blood flow, and sustained erection for a sufficient amount of time. It must be noted that for ED, Caverta 100 mg is recommended on an on-demand basis.

Pulmonary Arterial Hypertension (PAH)

PAH refers to the excessive pressure in the pulmonary artery that can be caused by physiological, genetic, and lifestyle reasons. Sildenafil is used for the treatment of this disorder as it has a vasodilatory effect on the pulmonary artery, restoring the blood flow to an optimum level. However, PAH is an off-label indication for Caverta 100 mg, and it must only be consumed if prescribed by the doctor.

Raynaud’s Phenomenon 

Raynaud’s phenomenon refers to the sudden narrowing of the arteries in the extremities, known as vasospasm. Sildenafil is used as an off-label treatment for Raynaud’s phenomenon. It maintains sufficient blood flow to these regions and reduces the frequency of vasospastic attacks.

Other Indications:

• High-Altitude Pulmonary Edema (HAPE) – prevention/treatment
• Digital ulcers associated with systemic sclerosis
• Secondary pulmonary hypertension (due to COPD, interstitial lung disease, heart failure)
• Chronic thromboembolic pulmonary hypertension (adjunct)
• Neonatal pulmonary hypertension (specialist use)
• Altitude-induced hypoxemia
• Heart failure with reduced ejection fraction (adjunct research use)
• Heart failure with preserved ejection fraction (investigational use)
• Erectile dysfunction secondary to diabetes mellitus
• Erectile dysfunction post-radical prostatectomy (penile rehabilitation)
• Antidepressant-induced sexual dysfunction (male)
• Female sexual arousal disorder (limited evidence)
• Intrauterine growth restriction (investigational)
• Placental insufficiency (research use)
• Assisted reproduction to improve endometrial thickness (experimental)
• Lower urinary tract symptoms associated with benign prostatic hyperplasia (adjunct)

Pulmonary hypertension secondary to congenital heart disease

Sickle cell disease–related pulmonary hypertension (specialist use)

Dosage Information

1.Erectile Dysfunction (On-label)

Recommended Dose:

• 50 mg orally taken once, 30–60 minutes before sexual activity

Maximum Dose:

• 100 mg once within 24 hours

Important Clinical Information:

• ½ a tablet of Caverta 100 mg can be consumed
• Dose may be increased to 1 tablet or reduced to ¼ tablet based on response.

2.Erectile Dysfunction in the Elderly (over 65 years) / Hepatic or Renal Impairment

Recommended Dose:

• 25 mg orally, once before sexual activity

Maximum Dose:

• 100 mg once every 24 hours

Important Clinical Information:

• Tablet consumption: Tablet splitting is required.
• A low dose is preferred as the drug has slow clearance.

3.Pulmonary Arterial Hypertension (Off-label use)

Recommended Dose:

• 20 mg orally, three times daily

Maximum Dose:

• 60 mg/day; it must be divided across multiple doses

Important Clinical Information:

• Tablet consumption: Tablet splitting is required 
• Caverta 100 mg is not ideal for this indication.

4.Indication: Raynaud’s Phenomenon (Off-label)

Recommended Dose:

• 25–50 mg orally, once or twice daily

Maximum Dose:

• 100 mg/day

Important Clinical Information:

• Tablet consumption: Tablet splitting is required.
• Used to improve peripheral circulation

5.High-Altitude Pulmonary Edema (Off-label)

Recommended Dose:

• 50 mg orally every 8–12 hours

Maximum Dose:

• 100 mg/day

Important Clinical Information:

• Tablet consumption: Tablet splitting is required.
• Use only under medical supervision.

6.Digital Ulcers associated with Systemic Sclerosis (Off-label)

Recommended Dose:

• 25–50 mg orally taken two to three times daily

Maximum Dose:

• 100 mg twice daily (200 mg/day under specialist supervision)

Important Clinical Information:

• This dosing is used to improve peripheral blood flow and promote healing of ischemic digital ulcers

7.Indication: Benign Prostatic Hyperplasia–Related LUTS (Adjunct, Off-label)

Recommended Dose:

• 25–50 mg orally once daily

Maximum Dose:

• 100 mg/day

Important Clinical Information:

• Tablet consumption: Tablet splitting is required.
• Caution when used with alpha-blockers

How Caverta 100mg Works

The active component present in Caverta 100 mg is 100 mg of sildenafil citrate. It targets the nitric oxide (NO)-cGMP pathway involved in the functioning of blood vessels in various anatomical systems. This pathway facilitates vascular smooth muscle relaxation, which promotes blood-vessel dilation.

Normally, the NO-cGMP pathway is activated in response to a certain signal (sexual stimulation, shear stress, endothelial signalling, etc.). Upon receiving such stimuli, NO is released either from the nerve endings or the endothelial cells. NO activates the enzyme guanylate cyclase, which converts GTP molecules to cyclic guanosine monophosphate (cGMP). cGMP molecules play a central role in the pathophysiology of several disease conditions, and their concentration must be optimum to prevent such conditions. 

cGMP causes decrease in the intracellular calcium levels, which leads to the relaxation of vascular smooth muscles. As a result, the blood vessels dilate, and the blood flow in the region is increased. 

To return the blood vessels back to its normal state, there is an enzyme known as phosphodiesterase type-5 (PDE-5), which is inherently present in the cells having the NO-cGMP pathway. It breaks down cGMP molecules and eventually fades their effects on the blood vessels. As a result, the blood vessels in the region go back to their normal size, and the blood flow is also reduced, compared to the enhanced flow observed after the cGMP effect.

It acts as a control switch in response to excess cGMP accumulation in the tissues. If cGMPs were allowed to persist indefinitely, then, the blood vessels would remain constantly dilated, the blood pressure would drop to an excessive extent, and vascular tone would be uncontrolled. 

However, in certain conditions, the effects of the PDE-5 enzyme are either observed prematurely or they are overexpressed. As a result, the minimum dilation of blood vessels, and relaxation of the smooth muscle tissues is also not achieved. For e.g., in erectile dysfunction, the overexpression of PDE-5 prevents sufficient blood flow to the penis and affects the normal working of the corpus cavernosum (penile erectile tissue).

The sildenafil citrate present in Caverta 100 mg targets the PDE-5 enzyme, thus preventing the breakdown of cGMP molecules. It promotes adequate vasodilation, mediated by the NO-cGMP pathways, thus allowing sufficient blood flow to the tissues. 

Possible Side Effects

1.Very Common / Common

• Headache
• Flushing (face/neck warmth, redness)
• Dizziness
• Indigestion (dyspepsia)
• Nausea
• Nasal congestion
• Stuffy or runny nose
• Diarrhoea
• Muscle pain
• Light-headedness
• Back pain
• Fatigue
• Insomnia

2.Eye / Vision-Related

• Blurred vision
• Visual disturbances
• Increased sensitivity to light
• Blue or green tinge to vision
• Difficulty distinguishing colors
• Sudden vision loss

3.Ear / Hearing-Related

• Ringing in ears (tinnitus)
• Decreased hearing
• Sudden hearing loss

4.Cardiovascular

• Low blood pressure (hypotension)
• Dizziness due to a blood pressure drop
• Palpitations
• Fast heartbeat
• Irregular heartbeat
• Chest pain
• Heart attack
• Stroke

5.Nervous System

• Headache
• Dizziness
• Vertigo
• Tingling sensation
• Numbness
• Confusion
• Fainting

6.Gastrointestinal

• Indigestion
• Nausea
• Vomiting
• Abdominal pain
• Diarrhoea
• Acid reflux

7.Respiratory / ENT

• Nasal congestion
• Sinus congestion
• Nosebleeds

8.Genitourinary / Sexual

• Prolonged erection
• Painful erection
• Priapism (erection longer than 4 hours)

9.Skin / Allergic

• Skin rash
• Redness
• Itching
• Swelling of the face, lips, tongue, or throat
• Allergic reactions

10.Other / General

• Sweating
• Fever
• General weakness
• Anxiety
• Body aches

Precautions and Considerations

• Caverta 100 mg must only be consumed under a licensed healthcare professional’s prescription. Do not self-medicate.
• Individuals must stick to the dosing concentration and timings prescribed by the healthcare professional.
• For ED, Caverta 100 mg is intended to be used on an on-demand basis. This dosing must not be consumed daily.
• Certain items cannot be consumed while taking Caverta 100 mg, such as alcohol and grapefruit.
• Caverta 100 mg is contraindicated with several medications including strong CYP3A4 inhibitors, nitrates, alpha-blockers, riociguat, and other PDE-5 inhibitors. 
• This medication must be administered carefully in patients with cardiovascular, hepatic, renal, neurological, hematological, ophthalmic and auditory conditions. 
• In patients suffering from cardiovascular disorders, specifically myocardial infarction or stroke, Caverta 100 mg must be avoided. 
  There must be regular monitoring of blood-pressure and cardiac parameters, in patients with cardiovascular conditions.
• Caverta 100 mg is not intended to be used by women, unless prescribed by the healthcare professional (very rare).
• In children, the use of Caverta 100 mg is not supported, however, in certain cases, medical care providers can recommend it for PAH.

Other Information

Frequently Asked Questions

1.How long does Caverta 100 mg take to work? How long does its effects last?

Caverta 100 mg usually takes 30-60 minutes to start working. Its effects usually last for 4-6 hours after consumption.

2.Does Caverta 100 mg cause an automatic erection?

No. Caverta 100 mg cannot spontaneously induce an erection. It requires sexual stimulation to work.

3.Can Caverta 100 mg be taken with food?

Yes. However, heavy or fat-rich meals can delay the on-set of the working of Caverta 100 mg.

4.Can Caverta 100 mg be taken with other medications?

Individuals must inform their healthcare provider about any existing medication before consuming Caverta 100 mg.

5.Does Caverta 100 mg cause addiction?

Caverta 100 mg does not affect the reward system of the brain in any manner. Hence, there are no reports of addiction caused due to Caverta 100 mg.