Is Sildenafil compatible with breastfeeding? Do we have alternatives for Sildenafil?


December 8, 2017 (Very Low Risk)

A 5-phosphodiesterase inhibitor used in the treatment of pulmonary hypertension, erectile dysfunction in men, Raynaud's syndrome and in other treatments due to its vasodilatory effect on smooth muscle.

Its use is authorized in small infants and neonates to treat pulmonary hypertension (Lakshminrusimha 2016, Krishnan 2010).

Sildenafil and its metabolite N-desmethylsildenafil are excreted in breast milk in clinically insignificant amounts, much lower than the dose used in newborns and infants (Wollein 2016).


We do not have alternatives for Sildenafil since it is relatively safe.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.


  • Sildenafil Citrate


  • σιλδεναφίλη κιτρική (Greek)
  • Сильденафила Цитрат (Cyrillic)
  • 酸塩 (Chinese)
  • シルデナフィルクエン (Japanese)
  • Sildénafil (French)
  • C22H30N6O4S,C6H8O7 (Molecular formula)
  • 5-[2-Ethoxy-5-(4-methylpiperazin-1-ylsulfonyl)phenyl]-1,6-dihydro-1-methyl-3-propylpyrazolo[4,3-d]pyrimidin-7-one citrate; 1-{[3-(6,7-Dihydro-1-methyl-7-oxo-3-propyl-1H-pyrazolo[4,3-d]pyrimidin-5-yl)-4-ethoxyphenyl]sulfonyl}-4-methylpiperazone citrate (Chemical name)


  1. EMA. Sildenafilo. Ficha técnica. 2016 Full text (in our servers)
  2. EMA. Sildenafil. Drug Summary. 2016 Full text (in our servers)
  3. Wollein U, Schech B, Hardt J, Schramek N. Determination and quantitation of sildenafil and its major metabolite in the breast milk of a lactating woman. J Pharm Biomed Anal. 2016Abstract
  4. Lakshminrusimha S, Mathew B, Leach CL. Pharmacologic strategies in neonatal pulmonary hypertension other than nitric oxide. Semin Perinatol. 2016Abstract
  5. Krishnan U. Management of pulmonary arterial hypertension in the neonatal unit. Cardiol Rev. 2010Abstract