Sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis) and avanafil (Stendra) are oral medications that reverse erectile dysfunction by enhancing the effects of nitric oxide, a natural chemical your body produces that relaxes muscles in the penis.
This increases blood flow and allows you to get an erection in response to sexual stimulation.
What is Viagra (sildenafil)?
Sildenafil (Viagra) is used to treat erectile dysfunction (impotence; inability to get or keep an erection) in men. Sildenafil (Revatio) is used to improve the ability to exercise in adults with pulmonary arterial hypertension (PAH; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness). Children should not usually take sildenafil, but in some cases, a doctor may decide that sildenafil (Revatio) is the best medication to treat a child’s condition.
Sildenafil is in a class of medications called phosphodiesterase (PDE) inhibitors. Sildenafil treats erectile dysfunction by increasing blood flow to the penis during sexual stimulation. This increased blood flow can cause an erection. Sildenafil treats PAH by relaxing the blood vessels in the lungs to allow blood to flow easily.
How does Viagra work?
Viagra works by increasing blood flow to your penis. It’s a reliable treatment for men who are unable to achieve an erection and those unable to maintain an erection. If you’re struggling with erectile dysfunction, this might be the right ED medicine for you.
So what exactly does Viagra do? By relaxing the arteries and muscles in the penis, this medication helps increase blood flow to the area. When you experience sexual arousal after taking this medicine, blood flows through the relaxed arteries to your penis, allowing you to achieve and maintain an erection. But don’t worry, you won’t get a spontaneous erection just from taking a pill. You have to be sexually aroused after taking this medicine to get an erection.
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How should Viagra be used?
Sildenafil comes as a tablet and suspension (liquid; Revatio only) to take by mouth.
If you are taking sildenafil to treat erectile dysfunction, follow your doctor’s directions and the guidelines in this paragraph. Take sildenafil as needed before sexual activity. The best time to take sildenafil is about 1 hour before sexual activity, but you can take the medication any time from 4 hours to 30 minutes before sexual activity. Sildenafil usually should not be taken more than once every 24 hours. If you have certain health conditions or are taking certain medications, your doctor may tell you to take sildenafil less often. You can take sildenafil with or without food. However, if you take sildenafil with a high-fat meal, it will take longer for the medication to start to work.
If you are taking sildenafil to treat PAH, follow your doctor’s directions and the guidelines in this paragraph. You will probably take sildenafil three times a day with or without food. Take sildenafil at around the same times every day, and space your doses about 4 to 6 hours apart.
Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take sildenafil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Shake the liquid well for 10 seconds before each use to mix the medication evenly. Use the oral syringe provided with your medication to measure and take your dose. Follow the manufacturer’s directions to use and clean the oral syringe. Do not mix the liquid with other medications or add anything to flavor the medication.
If you are taking sildenafil for erectile dysfunction, your doctor will probably start you on an average dose of sildenafil and increase or decrease your dose depending on your response to the medication. Tell your doctor if sildenafil is not working well or if you are experiencing side effects.
If you are taking sildenafil for PAH, you should know that sildenafil controls PAH but does not cure it. Continue to take sildenafil even if you feel well. Do not stop taking sildenafil without talking to your doctor.
Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.
What are the risks and warnings for Viagra (sildenafil)?
Viagra (sildenafil) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options
RISK OF HEART ATTACK OR STROKE
- Risk factors: Existing heart condition | Recent heart attack or stroke in past 6 months | High or low blood pressure
It’s not recommended for men to take Viagra (sildenafil) if they’ve had a heart attack, stroke, or symptoms of heart failure in the past 6 months, abnormal blood pressure, or if they have chest pain. The safety of Viagra (sildenafil) has not been studied in these situations. Talk to your doctor if you have any of these health conditions.
LOW BLOOD PRESSURE
- Risk factors: Taking alpha blockers | Taking medications for high blood pressure or chest pain (angina) | Drinking alcohol
If you’re taking alpha blockers or medications for high blood pressure with Viagra (sildenafil), your blood pressure may drop too low. Make sure to check your blood pressure regularly if you’re taking these other medicines. Be very careful getting up from a sitting or lying down position since this can make you feel dizzy and more likely to fall. Drinking alcohol can also cause low blood pressure. Avoid or lower your alcohol consumption when taking Viagra (sildenafil). You should never take Viagra (sildenafil) when taking nitrate medication for chest pain (angina) because it can cause your blood pressure to suddenly drop to unsafe levels.
- Risk factors: Peyronie’s disease | Cavernosal fibrosis | Sickle cell anemia
There have been reports of men having an erection lasting more than 4 hours while on Viagra (sildenafil). This is rare but if it’s not treated in time, it can cause permanent damage to your penis, including permanent impotence. Get medical help immediately if this happens.
If you suddenly notice changes in your vision in one or both eyes, go to the emergency room or call your doctor immediately. Although this is rare, Viagra (sildenafil) can cause permanent eye damage.
There have been reports of men having permanent hearing loss while taking Viagra (sildenafil). This may happen along with ringing in the ears (tinnitus) and dizziness. Go to the emergency room or call your doctor immediately if you notice changes in your hearing in one or both ears.
INCREASED SIDE EFFECTS WITH OTHER MEDICINES
- Risk factors: Age 65 years or older | Liver disease | Kidney disease | Taking medications such as nitrates, anti-hypertensives, alpha blockers, ketoconazole, or ritonavir
You may experience more side effects while taking Viagra (sildenafil) if you are also taking medications called nitrates for chest pain, blood pressure medications, certain medications for HIV, are elderly, or have liver or kidney disease. Talk to your doctor before starting Viagra (sildenafil) if any of these apply to you.
How to take Viagra
Take 1 Viagra pill one hour before sex. Never take more than one pill on the same day.
Grapefruit can increase the risk that you experience side effects, so don’t eat grapefruit or drink grapefruit juice on the same day as using Viagra.
Take this medication only as needed. The usual starting dosage is 50mg but your doctor or nurse practitioner might start you on a different dose based on your unique medical history. This medication isn’t suitable for everyone and shouldn’t be taken if you’re also on a nitrate drug for heart problems. If you’re struggling with ED as well as a heart condition, please consult with a doctor or nurse practitioner before taking this medication.
Wondering when to take Viagra? Take it an hour or so before you plan to have sex since this medicine takes at least 30-60 minutes of taking it for it to work. If you have any other questions about how to take Viagra, our medical team is available and ready to answer them.
Viagra vs Sildenafil
Viagra and sildenafil are medically the same, containing the same active ingredient sildenafil. The main difference is price where generic sildenafil is cheaper than branded Viagra (sold by Pfizer). Also, sildenafil is available in 20mg dosage. Viagra comes in diamond shaped blue pills and sildenafil comes in white or blue tablets. Both are equally effective for the treatment of erectile dysfunction.
Viagra side effects
Sildenafil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- flushing (feeling of warmth)
- difficulty falling asleep or staying asleep
- numbness, burning, or tingling in the arms, hands, feet, or legs
- muscle aches
- changes in color vision (seeing a blue tinge on objects or having difficulty telling the difference between blue and green)
- sensitivity to light
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:
- sudden severe loss of vision (see below for more information)
- blurred vision
- sudden decrease or loss of hearing
- ringing in ears
- dizziness or lightheadedness
- chest pain
- worsening shortness of breath
- erection that is painful or lasts longer than 4 hours
- itching or burning during urination
Some patients experienced a sudden loss of some or all of their vision after they took sildenafil or other medications that are similar to sildenafil. The vision loss was permanent in some cases. It is not known if the vision loss was caused by the medication. If you experience a sudden loss of vision while you are taking sildenafil, call your doctor immediately. Do not take any more doses of sildenafil or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor.
There have been reports of heart attack, stroke, irregular heartbeat, bleeding in the brain or lungs, high blood pressure, and sudden death in men who took sildenafil for erectile dysfunction. Most, but not all, of these people had heart problems before taking sildenafil. It is not known whether these events were caused by sildenafil, sexual activity, heart disease, or a combination of these and other causes.Talk to your doctor about the risks of taking sildenafil.
Some patients experienced a sudden decrease or loss of hearing after they took sildenafil or other medications that are similar to sildenafil. The hearing loss usually involved only one ear and did not always improve when the medication was stopped. It is not known if the hearing loss was caused by the medication. If you experience a sudden loss of hearing, sometimes with ringing in the ears or dizziness, while you are taking sildenafil, call your doctor immediately. If you are taking sildenafil (Viagra) for erectile dysfunction, do not take any more doses of sildenafil (Viagra) or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor. If you are taking sildenafil (Revatio) for PAH, do not stop taking your medication until you talk to your doctor.
Sildenafil may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
Buying oral erectile dysfunction medications online
Treatments for erectile dysfunction are big business, and online scams abound. If you do buy medications over the internet:
- Check to see if an online pharmacy is legitimate. Never order medications from an online pharmacy if there’s no way to contact the pharmacy by phone, if prices seem too good to be true or if you’re told no prescription is necessary. Some illegal businesses sell counterfeit versions of legitimate medications, which can be ineffective or dangerous. In the U.S., the National Association of Boards of Pharmacy can tell you whether an online pharmacy is licensed and in good standing.
- Make sure you get the right prescription and dose. When you order medications — and when you receive them in the mail — make sure they’re the exact dose and type prescribed by your doctor.
- Don’t be fooled into buying ‘herbal viagra.’ Never take any medications that claim to be the “herbal” or nonprescription equivalent of an oral medication for erectile dysfunction. These aren’t an effective alternative, and some contain harmful substances.
Interactions between Viagra (sildenafil) and other medications
Viagra (sildenafil) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Viagra (sildenafil). Please note that only the generic name of each medication is listed below.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Amyl Nitrite
- Erythrityl Tetranitrate
- Isosorbide Dinitrate
- Isosorbide Mononitrate
- Pentaerythritol Tetranitrate
- Propatyl Nitrate
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
How to use Viagra ?
Read the Patient Information Leaflet provided by your pharmacist before you start taking sildenafil and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
To treat erectile dysfunction-ED, take this drug by mouth as directed by your doctor, usually as needed. Take sildenafil at least 30 minutes, but no more than 4 hours, before sexual activity (1 hour before is the most effective). Do not take more than once daily.
A high-fat meal may delay how quickly the drug begins to work.
The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
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