Fildena 120 mg contains sildenafil, a phosphodiesterase type 5 (PDE5) inhibitor, commonly used for erectile dysfunction. Its metabolism and clearance are heavily dependent on the liver, so liver disease can significantly affect its safety. Here’s why it should be avoided or used with caution in liver disease: 1. Hepatic Metabolism Sildenafil is primarily metabolized in the liver by the CYP3A4 and CYP2C9 enzymes. In liver disease (e.g., cirrhosis, hepatitis), these enzymes may be impaired. Impaired metabolism leads to higher blood concentrations of the drug, increasing the risk of side effects. 2. Increased Risk of Side Effects Elevated Fildena 120 mg levels can cause more severe adverse effects, including: Hypotension (dangerous drop in blood pressure) Headache, dizziness, and flushing Vision or hearing changes Priapism (painful prolonged erections) In severe liver disease, these effects can be life-threatening due to already compromised organ function. 3. Liver Disease Complications Patients with liver disease may have portal hypertension, coagulopathy, or fluid retention, which can worsen with the vasodilatory effects of sildenafil. Liver dysfunction also increases sensitivity to drugs that affect cardiovascular function. 4. Dose Adjustment or Avoidance In mild to moderate liver impairment, a lower dose may sometimes be considered, but in severe liver disease, sildenafil is generally contraindicated. Summary: Fildena 120 mg should be avoided in liver disease mainly because the liver cannot metabolize sildenafil efficiently, leading to accumulation and higher risk of serious side effects, especially cardiovascular complications.