Erectile dysfunction (ED) is defined as a man's inability to achieve or maintain an
erection long enough to complete sexual activity. Sildenafil (SILD) is a drug that is used to treat
ED all over the world. In this review article, the interactions between SILD and herbal
supplements recorded in the literature were summarized using the Medline database (via
PubMed) and the key-words: Sildenafil, herbal supplements, and interactions. In the present
review article, pharmacokinetic (PK) and pharmacodynamic (PD) interactions were reported
during co-administration of herbal supplements with SILD. Reduction in SILD bioavailability
was found as a result of interaction of SILD with Horny goat weed, Thai ginseng, Arugula,
Black seed, Garden cress, Fenugreek, and Pummelo juice in human and/or animal models.
Meanwhile, Citrus lemon juice has not significantly altered the PK of SILD. Also, PD
interactions were found as a result of the interaction of Curcumin, Yohimbine, and
Pomegranate juice in human and rat models. Healthcare professionals should be aware of this
potential and researchers should strive to fill the numerous gaps in our present understanding
of this problem.