01What sudden vision loss asks you to do
Stop the tablet. Seek medical attention. Do not take another 50 mg to 'see if it clears'.
Say that sildenafil was taken. Bring the bottle if you have it.
02How NAION is named on the insert
Non-arteritic anterior ischemic optic neuropathy is a rare cause of decreased vision, including permanent loss, reported post-marketing in temporal association with PDE5 inhibitors. Published annual incidence is 2.5 to 11.8 cases per 100,000 in men aged 50 and older. An observational study suggested about a 2-fold increase in NAION risk within 5 half-lives of PDE5 use.
It is not possible, from that information, to say the events are caused only by the tablet.
03When both eyes or one eye still stop
The warning says one or both eyes. Unilateral loss still stops the class.
Headache and flush listed first are common effects. They are not this stop.
04What hearing drop sits in the same stop
Sudden decrease or loss of hearing, sometimes with tinnitus and dizziness, has been reported in temporal association with PDE5 inhibitors. Stop and seek prompt care. Follow-up information in many cases was limited.
Again, causality versus underlying risk is not settled on the insert.
05Who already had NAION needs extra caution
People who already had NAION are at higher risk of recurrence. Use PDE5 inhibitors only if expected benefit outweighs that risk. A crowded optic disc is also considered higher risk; evidence is not enough to screen every future user.
NAION and hearing stops apply at 25 mg and at 50 mg on the sildenafil 25-50 mg vault.
06Why a blue tinge is a different row
Abnormal vision in the trials was mostly a mild, transient color tinge, plus light sensitivity or blur. At 50 mg that row was 2% versus 1% on placebo; at 25 mg it was 1%. At 100 mg it was 11%.
A color tinge that fades with the plasma curve is not the NAION stop. Sudden blackout of an eye is.