Assurans (Sildenafil Citrate)

Common Use

Assurans contains the active ingredient sildenafil, which belongs to a class of medications called phosphodiesterase type 5 (PDE5) inhibitors. In simple terms, it works by relaxing and widening the blood vessels in the lungs, which allows more blood and oxygen to flow through, reducing the pressure in the pulmonary arteries.

Assurans is used primarily to treat pulmonary arterial hypertension (PAH) —a condition where the blood pressure in the arteries of the lungs is abnormally high. This condition affects the pulmonary artery, pulmonary vein, and pulmonary capillaries (collectively known as the lung vasculature). Symptoms of PAH include:

Shortness of breath (dyspnea), especially during physical activity

Dizziness or fainting (syncope)

Fatigue

Swelling in the ankles and legs

Chest pain

By reducing pulmonary blood pressure, Assurans helps improve exercise ability and overall quality of life for patients with this condition.

Important note: Because sildenafil is the same active ingredient found in Viagra, Assurans is also sometimes used off-label for the treatment of erectile dysfunction (ED) —a condition where a man has difficulty achieving or maintaining an erection firm enough for sexual activity. However, the dosage for pulmonary hypertension is different from that used for erectile dysfunction.

Dosage and Direction

For the treatment of pulmonary arterial hypertension:

Take one Assurans tablet of 20 mg three times a day

Each dose should be separated by 4–6 hours

You may take it with or without food—whatever suits you best

Regular intakes separated by equal time periods (for example, morning, midday, and evening) are preferable to maintain consistent levels of the medication in your body

Important: Do not take more than the prescribed dose. If you are using Assurans for erectile dysfunction, the dosage and directions are different—consult your doctor for the appropriate dosing.

Precautions

Before taking Assurans, notify your doctor if you have a history of:

Heart attack (myocardial infarction)

Stroke (cerebrovascular accident)

Irregular heartbeat (arrhythmia)

Chest pain (angina)

High or low blood pressure (hypertension or hypotension)

Blood vessel disorders or problems with blood circulation

Retinitis pigmentosa – a rare inherited eye disease

Liver disease or kidney disease

Deformation of the penis (such as Peyronie’s disease, curved penis, or birth defects of the penis)

Sickle cell anemia – a blood disorder that can cause painful erections

Porphyria – a rare blood disorder affecting the nervous system and skin

Cancer of the blood cells or bone marrow (such as leukemia or multiple myeloma)

Stomach ulcers or stomach bleeding

Special warning: Pulmonary vasodilators such as Assurans may significantly worsen the cardiovascular status of patients with pulmonary veno-occlusive disease (PVOD) —a rare condition where the small veins in the lungs become blocked. If you have this condition, your doctor will monitor you closely.

Contraindications

Assurans is contraindicated—meaning you should not take it—in the following situations:

Children younger than 12 years of age (safety and effectiveness have not been established)

Patients taking any medications that contain organic nitrates – this combination can cause a dangerous drop in blood pressure

Known hypersensitivity (allergy) to sildenafil or any of its components

Possible Side Effects

Assurans is mostly well tolerated, but side effects may occur.

Common side effects may include:

Fever

Flushing (redness and warmth of the face, neck, or chest)

Headache

Muscle aches

Nasal infection or stuffy nose

Nosebleeds

Shortness of breath

Sleeplessness (insomnia)

Sinus infection (sinusitis)

Upset stomach (dyspepsia)

Nausea

Less common but more serious side effects may include:

Priapism – a painful erection lasting more than 4 hours; seek immediate medical help

Sudden vision loss – in one or both eyes (rare)

Sudden hearing loss or ringing in the ears

Severe allergic reactions – rash, swelling, difficulty breathing

In case of serious or persistent adverse effects, call your doctor immediately—you may need immediate medical help.

Drug Interactions

Assurans can interact with several medications. Do not take Assurans with:

Any drugs containing sildenafil (such as Viagra, Kamagra, or other brands) – taking multiple PDE5 inhibitors together increases the risk of side effects

Organic nitrates – such as nitroglycerin, isosorbide mononitrate, isosorbide dinitrate, and recreational drugs like amyl nitrite (“poppers”). This combination can cause a life-threatening drop in blood pressure

Antifungal drugs such as ketoconazole and itraconazole – these can increase sildenafil levels

Ritonavir and other HIV protease inhibitors – can significantly increase sildenafil levels

Inform your doctor if you are taking:

Alpha-blockers (such as doxazosin, tamsulosin) – used for high blood pressure or enlarged prostate; combining them with Assurans may cause low blood pressure

Barbiturates

Bosentan – used for pulmonary hypertension

Carbamazepine, phenytoin, rifampin, rifabutin – these can decrease sildenafil levels

Vitamin K antagonists (blood thinners such as warfarin) – your dose may need monitoring

Always inform your doctor about all medications and herbal products you are taking, including over-the-counter products and supplements.

Missed Dose

If you miss a dose, take it as soon as you remember—unless it is almost time for your next dose. If that’s the case, skip the missed dose and return to your regular schedule. Do not take two doses at once to make up for a missed one.

Overdose

Symptoms of Assurans overdose are similar to those seen at lower doses, but their frequency and severity are increased. If you suspect that you have taken too much of this medication, you should seek immediate medical help.

Storage

Store Assurans at room temperature between 15–30°C (59–86°F), away from children, pets, moisture, and direct sunlight.

Disclaimer

We provide only general information about medications, which does not cover all directions, possible drug interactions, or precautions. Information on this site cannot be used for self-treatment or self-diagnosis. Any specific instructions for a particular patient should be agreed upon with your healthcare adviser or the doctor in charge of your case. We disclaim reliability of this information and any mistakes it may contain. We are not responsible for any direct, indirect, special, or other indirect damage as a result of any use of the information on this site, nor for the consequences of self-treatment.

About Our Service Cydoctors.com is an online pharmacy based right here in Cyprus. We understand that managing pulmonary hypertension requires consistent, reliable access to your medication—so we’ve made our service straightforward, dependable, and built with your convenience in mind. Because we’re local to the island, we can arrange delivery in the shortest possible time. For our customers in Nicosia, Limassol, and Larnaca, we’re pleased to offer overnight delivery, so your Assurans can be with you by the next day, helping you breathe easier and stay active without any unnecessary stress.