Sildenafil – What It Does, How It Affects Bleeding, and How to Use It Safely

If you’ve heard of sildenafil, you probably know it by the brand name Viagra. It’s a pill that relaxes blood vessels in the penis, helping men get and keep an erection. Doctors also use it for pulmonary arterial hypertension because it lowers pressure in the lungs. The dose for erectile dysfunction (ED) is usually 25‑100 mg taken about an hour before sexual activity, while the hypertension dose is lower and taken daily. Knowing the right dose and purpose makes a big difference in safety.

Bleeding Risk and the CRUSADE Bleeding Score

When you’re on blood thinners or have a heart condition, bleeding risk becomes a key concern. The CRUSADE Bleeding Score is a tool clinicians use to predict how likely a patient on antiplatelet therapy is to bleed. Sildenafil itself isn’t an antiplatelet, but it can interact with nitrates and some anticoagulants, raising bleed risk. If a patient already has a high CRUSADE score, doctors will weigh the benefits of sildenafil against the chance of a bleed. In practice, this means checking blood pressure, heart rhythm, and any recent surgeries before starting the drug.

Practical Safety Tips for Patients and Clinicians

Here’s a quick checklist you can use:

1. Talk to your doctor. Mention every medication you take – especially nitrates, alpha‑blockers, and blood thinners. Even over‑the‑counter supplements can matter.

2. Follow the prescribed dose. Taking more than 100 mg won’t improve results, but it can raise side‑effects like headache, flushing, or rare bleeding events.

3. Watch for warning signs. If you notice unusual bruising, nosebleeds, or blood in urine, call your healthcare provider right away.

4. Keep track of timing. If you’re on a nitrate, wait at least 24 hours after the last dose before taking sildenafil. The opposite timing also matters – don’t take a nitrate within a few hours after sildenafil.

5. Review your CRUSADE score. Your clinician can calculate it using lab values, blood pressure, and medical history. A high score means extra caution.

In summary, sildenafil works well for ED and certain lung conditions, but it isn’t a free‑for‑all drug. Understanding how it fits into a patient’s overall bleeding risk profile, especially with the CRUSADE score, helps keep treatment both effective and safe. If you have any doubts, ask your doctor to walk you through the risk assessment – it’s worth a few extra minutes for peace of mind.