Foreword and purpose

Fildena is a brand that contains sildenafil citrate, a phosphodiesterase type 5 (PDE-5) inhibitor. It is sold in a variety of countries and some Fildena products are imported or manufactured in formulations that differ from medicines formally licensed in the United Kingdom.

The primary indication for sildenafil is treatment of erectile dysfunction in adult men. It assists the natural process of erection in response to sexual stimulation but it does not create sexual desire, act as contraception, or prevent sexually transmitted infections.

To read about the drug's pharmacology, go to Sildenafil acts to increase blood flow. For a comparison with other options and approximate UK costs see A UK price handbook and its additional choices.

Sildenafil the method by which it operates and effect

During sexual arousal the penis releases nitric oxide, which increases cyclic guanosine monophosphate (cGMP) in smooth muscle cells. cGMP causes the blood vessels in the penis to relax and fill with blood. Sildenafil inhibits the PDE-5 enzyme that breaks down cGMP, so by slowing that breakdown it helps sustain the increased blood flow needed for an erection while sexual stimulation continues.

Strengths available and dosing guidelines

Fildena tablets offered by different suppliers may include several doses. Common strengths seen internationally are 25 mg, 50 mg and 100 mg. Some overseas sources sell higher strengths that are not typical in UK practice.

In the UK sildenafil is normally dispensed in 25 mg, 50 mg and 100 mg strengths. For most men the usual maximum single dose is 100 mg. Larger single doses are rare and should only be used under specialist supervision.

Typical practical guidance on dosing for adults (information only):

  • Standard starting dose: 50 mg taken about one hour before sexual activity.
  • If the 50 mg dose is tolerated but not effective, a clinician may advise increasing to 100 mg.
  • Consider 25 mg if medication side effects are prominent, for older patients, or when interacting medications or health issues are present.
  • Only a single dose may be taken in each 24 hour period.

How to take on a challenge Fildena in the right way

Guidance on administration:

  • Swallow the tablet with water. Taking it on an empty stomach usually gives a faster onset; a large fatty meal can delay absorption.
  • Take the tablet 30 to 60 minutes before planned sexual activity. Some men notice effects within 30 minutes. Effects commonly last up to around four hours for sildenafil.
  • Avoid heavy alcohol consumption when using sildenafil as excess alcohol can reduce effectiveness and increase the risk of negative effects such as dizziness.
  • Remember sexual stimulation is required for an erection to occur; sildenafil does not act as an aphrodisiac.

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Preserve and handle recommendations

  • Store tablets at normal room temperature, ideally below 30 C, in a dry place.
  • Keep the medicine in its original packaging to protect from moisture and light.
  • Keep it out of reach and out of sight for children and pets.
  • Do not use once the expiry date on the pack has passed.

Cautions and contraindicated uses

Do not take sildenafil if any of the following apply:

  • A known hypersensitivity to sildenafil or to any ingredient in the tablet.
  • Concurrent use of nitrates or nitric oxide donors, for example nitroglycerin or amyl nitrite, because the combination can cause a dangerous drop in blood pressure.
  • Use of riociguat for pulmonary hypertension.
  • Severe cardiovascular disease that makes sexual activity unsafe, recent heart attack or stroke, unstable angina, or uncontrolled low blood pressure.
  • Severe impairment of hepatic or nephritic function unless your specialist advises otherwise.
  • History of certain eye disorders such as non-arteritic anterior ischemic optic neuropathy or inherited retinal diseases like retinitis pigmentosa.
  • Concurrent use of another PDE-5 inhibitor or a different erectile dysfunction therapy.
  • Sildenafil is intended for adult men; it is not licensed for use in women or children.

Seek advice a healthcare professional before starting sildenafil if you are at risk of priapism (for example due to sickle cell disease, multiple myeloma or leukemia), have bleeding disorders, an active stomach ulcer, or penile anatomical deformities.

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  • Nitrates and nitric oxide donors: strictly contraindicated with sildenafil.
  • Alpha blockers: combining these can produce symptomatic hypotension; timing and dosage should be reviewed by a clinician.
  • Strong CYP3A4 inhibitors (for example ritonavir, cobicistat, ketoconazole, itraconazole) may raise sildenafil levels and could require dose adjustment or avoidance.
  • CYP3A4 inducers such as rifampicin, carbamazepine, phenytoin and St. Johns wort may reduce sildenafil concentrations and its effect.
  • Large amounts of grapefruit juice can increase sildenafil blood levels.
  • Recreational drugs including amyl nitrite "poppers" and certain stimulants can interact dangerously and should not be mixed with sildenafil.

Possible collateral effects and when to get urgent help

Many men experience no or only mild, short-lived harmful consequences.

Frequent drug after effects include head pains, facial flushing, nasal congestion, indigestion, dizziness, transient visual disturbances such as a blue tint or blurred vision, and muscle or back pain. Reactions that are uncommon include nausea, abdominal discomfort, palpitations or skin rash.

Seek immediate medical attention if any of the following occur:

  • An erection lasting longer than four hours (priapism).
  • Sudden monocular or binocular vision loss., or acute hearing loss.
  • Severe chest pain, fainting, or symptoms of a severe allergic reaction such as breathing difficulties or swelling of the face, lips or tongue.

Additional pathways to sildenafil and UK price a general overview

Other prescription treatments and options for erectile dysfunction include:

  • Other oral PDE-5 inhibitors: tadalafil, vardenafil and avanafil.
  • Topical or intraurethral alprostadil formulations and intracavernosal injections containing alprostadil or combination therapies.
  • Mechanical devices such as vacuum erection devices (penis pumps).
  • Penile prosthesis surgery in selected cases.
  • Psychosexual therapy, counselling and lifestyle interventions, which are important when psychological factors contribute to erectile problems.

Approximate private retail discount pricing ranges in the UK (per tablet or typical unit, variable by dose and pack size):

  • Generic sildenafil (25-100 mg): about 0.40 to 2.50 GBP per tablet.
  • Viagra brand (25-100 mg): commonly 4.50 to 10.00 GBP per tablet.
  • Generic tadalafil (5-20 mg): roughly 0.70 to 2.50 GBP per tablet; Cialis brand often 4.00 to 8.00 GBP.
  • Generic vardenafil (5-20 mg): around 1.50 to 4.50 GBP; Levitra brand about 3.50 to 8.00 GBP.
  • Avanafil (Spedra, 50-200 mg): approximately 5.00 to 9.00 GBP per tablet.

Other options cost approximately:

  • Vacuum-assisted penile erection apparatus: roughly 40 to 250 GBP depending on model and supplier.
  • Alprostadil injections or urethral pellets: prices vary widely; individual doses may cost from a few pounds to several tens of pounds depending on formulation and supply arrangements.
  • Penile implant surgery: usually several thousand pounds private sector, often in the region of 4000 to 12000 GBP depending on the procedure and clinic.

Start point and length comparison:

  • Sildenafil: onset typically 30 to 60 minutes; duration up to about four hours.
  • Tadalafil: similar onset for many, but duration can extend up to 36 hours; also available in low-dose daily regimens.
  • Vardenafil: profile similar to sildenafil for many men; individual tolerability varies.
  • Avanafil: may work faster for some people, sometimes within 15 to 30 minutes; duration shorter than tadalafil.

Note: Fildena is often supplied from outside the UK and may be unlicensed by the MHRA. For assured quality consider UK-licensed generics or branded products obtained through regulated pharmacies or NHS services.

Designed for sport use

Sildenafil is not an approved performance enhancing medication. It is generally not listed as prohibited by major anti-doping agencies, but athletes should check current guidance from UK Anti-Doping (UKAD) and WADA and follow any team or event medical requirements. Only use erectile dysfunction medicines for legitimate medical markers and under the supervision of a healthcare professional.

Additional aspects about Fildena