The intro and quick facts

Sildenafil is the active molecule in products often marketed as Viagra. It is a member of the phosphodiesterase type 5 inhibitor family and is commonly prescribed to treat erectile dysfunction in adult men. Distinct formulations and dosing schedules of sildenafil are also licensed for pulmonary arterial hypertension and are prescribed by specialists for that indication.

Notable points at a glance:

  • Primary active moiety: sildenafil (usually as sildenafil citrate)
  • Common primary use in general practice: erectile dysfunction in adult males
  • Separate specialist products exist for pulmonary hypertension
  • ED tablet strengths typically available include 25 mg, 50 mg and 100 mg

For practical directions see Dosing and practical tips. For test thiss to consider before starting, consult Protective safety guidelines and Cooperative exchanges between medications.

How the drug sildenafil works

Sildenafil enhances the normal physiological process that leads to an erection. During sexual stimulation nitric oxide is released in the penis, which increases cyclic GMP levels. Cyclic GMP relaxes smooth muscle in penile blood vessels, allowing increased blood flow. By inhibiting the PDE5 enzyme, sildenafil reduces the breakdown of cyclic GMP and helps sustain the response.

Important: sildenafil supports the erection process but does not cause an erection without sexual arousal.

Dosing and practical tips

The following patterns are those commonly used for erectile dysfunction. Always follow the specific advice provided by your prescriber or the pharmacist supplying the medicine.

  • Usual starting dose: 50 mg, taken about 30 to 60 minutes before sexual activity.
  • Adjustment: based on efficacy and follow-on effects the dose can be reduced to 25 mg or increased to 100 mg. Do not take more than one dose in twenty four hours.
  • Food: a large high fat meal can slow the onset; sildenafil usually acts faster on an empty stomach.
  • Avoid grapefruit and grapefruit juice while taking sildenafil since they can increase blood levels of the drug.
  • Avoid heavy alcohol consumption immediately before sexual activity as it may lessen the effect and raise the likelihood of dizziness.

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Safety, adhere to measures for safety and warning announcements

Look over these precautionary actions and discuss any concerns with a healthcare professional before using sildenafil.

  • Allergies: do not use sildenafil if you have a known hypersensitivity to the active substance or any excipient in the tablet.
  • Heart conditions: sexual activity can increase cardiac workload. Ask for counsel a clinician if you have unstable angina, recent myocardial infarction or stroke, severe heart failure, or poorly controlled blood pressure.
  • Hearing and vision: rare reports describe sudden hearing loss or sudden vision loss. Stop the medicine and seek urgent care if these occur.
  • Elderly: older adults may show greater sensitivity to hypotension and dizziness; dose adjustments may be required.
  • Not for women or children for ED; pulmonary hypertension formulations are managed separately by specialists.

Inspect the document absolute exclusions details Who should avoid sildenafil. If you experience chest pain, fainting, or an erection lasting longer than four hours (priapism), get immediate medical assistance.

Who should avoid sildenafil

  • Anyone taking nitrates in any form, including sprays or patches; the combination can produce a dangerous drop in blood pressure.
  • Patients currently treated with riociguat for some types of pulmonary hypertension.
  • People advised by a clinician to abstain from sexual activity due to cardiovascular risk.
  • Individuals with a known allergy to sildenafil or any tablet ingredient.
  • Concurrent use of other PDE5 inhibitors is not recommended.

If you are uncertain whether these apply to you, consult a pharmacist or prescriber before taking sildenafil.

Common and major drug postmarketing effects

Sildenafil is well tolerated by many users. When residual effects occur they are most often mild or temporary. Frequent behavioral reactions include:

  • A mild head pain accompanied by facial flushing
  • Gastrointestinal distress or abdominal unease
  • Persistent nasal congestion with runny nose
  • Giddiness or lightheadedness
  • Temporary visual changes such as altered color perception or increased light sensitivity
  • Diarrhoea presentation

Visit the emergency department for a severe injury chest pain, fainting, sudden vision loss, sudden hearing loss, or priapism lasting more than four hours. For information on keeping your medicine safe see Block data storage solutions include cloud storage, hard drives, and optical media. and protection.

Interaction with other medicines

Sildenafil interacts with a number of prescription, over-the-counter and herbal preparations. Always show your full medicine list to any clinician or pharmacist prior to starting sildenafil.

  • Nitrates and amyl nitrite "poppers" are strictly contraindicated due to severe hypotension risk.
  • Alpha blockers such as tamsulosin or doxazosin may increase the risk of symptomatic low blood pressure; careful timing and go over are advisable.
  • Strong CYP3A4 inhibitors, for example ritonavir, cobicistat, ketoconazole or clarithromycin, can increase sildenafil exposure; a lower starting dose may be recommended.
  • Do not join. sildenafil with other PDE5 inhibitors such as tadalafil, vardenafil or avanafil.
  • Antihypertensive medicines and alcohol can add to the blood pressure lowering effects and increase dizziness risk.

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Help with omitted doses and deliberate overdose scenarios.

For erectile dysfunction sildenafil is usually taken as required rather than on a regular schedule. If you skip a planned dose there is no replacement dose to take; only use sildenafil when needed and do not exceed one dose in any 24 hour period.

In the event of an non fatal overdose seek emergency medical care. Signs may include extreme dizziness, fainting, severe chest pain, rapid heart rate, nausea or marked vision disturbance. Bring the medicine packaging to help clinicians identify the product and dose.

Handling and storage management helps organize and track items.

  • Keep tablets at normal room temperature, roughly 20 to 25 C (68 to 77 F).
  • Protect from moisture and strong light; do not store in bathrooms or other damp areas.
  • Keep medicines stored in a place that is out of reach and not visible to children and pets.
  • Do not use any product beyond the expiry date printed on the pack.

Other medicines in conjunction with their analogs

If sildenafil is not suitable or effective there are other therapeutic options. Do not put together. these with sildenafil unless directed by a clinician.

  • Tadalafil (Cialis) - typically has a longer duration and can be prescribed as a daily low dose or on demand for extended coverage.
  • Vardenafil (Levitra) - generally similar onset and duration to sildenafil for many individuals.
  • Avanafil brand Spedra - some users report a faster onset of effect.
  • Generic sildenafil - contains the same active ingredient as branded Viagra but usually at a lower price.
  • Non-drug approaches - vacuum erection devices, intracavernosal injections, penile implants, lifestyle changes and psychological therapy as indicated.

See cost comparisons in A guide to Prices across Britain using GBP and procurement rules in Regulatory and legal commentary (UK).

GBP price forecasting guide and reference for the UK

The following are approximate private retail prices in Great Britain. Actual cost varies by pharmacy, pack size, strength and whether you buy branded or generic products. NHS prescribing rules and local decisions may limit routine prescribing of ED medicines.

  • Viagra Connect 50 mg (available from a pharmacy after pharmacist assessment): commonly about 20 to 25 GBP for 4 tablets; larger packs cost more but reduce per-tablet price.
  • Generic sildenafil 50 mg or 100 mg (private purchase): often around 5 to 15 GBP for a small pack of 4 tablets, depending on supplier and strength.
  • Tadalafil 10 mg or 20 mg (private): roughly 15 to 30 GBP for a pack of 4 tablets.
  • Vardenafil 10 mg or 20 mg (private): typically 20 to 35 GBP for 4 tablets.
  • Spedra, Avanafil 50 to 200 mg (private): frequently 50 to 70 GBP for 4 tablets.

NHS prescriptions: a per-item prescription charge may apply in England for patients who are not exempt. Prescriptions are generally free in Scotland, Wales and Northern Ireland. Purchasing larger pack sizes or generics usually lowers the cost per dose; private clinics, expedited services and home delivery may add fees.

Used in sport

Sildenafil is currently not included on the World Anti-Doping Agency prohibited list. However, athletes should check with their team doctor, national governing body or competition rules before using any medication. Evidence that sildenafil improves athletic performance at sea level is limited; some data have considered effects at high altitude. Consider potential drug side effects and online people relating to one anothers connect users across distances. before use in a competitive setting.

Extra resources for help and contacts

For personalised advice on suitability and dosing speak to your GP, a UK-registered pharmacist or a specialist sexual health clinic. In a life threatening emergency or severe allergic reaction call 999 or attend your nearest emergency department. For routine supply questions a pharmacist can advise about Viagra Connect and whether a prescription is required.

Recommended actions:

  • Provide a complete medication list to any clinician before starting sildenafil.
  • Report serious deleterious effects to your prescriber and to the Yellow Card Scheme in the UK.
  • When buying online use only reputable UK-registered pharmacies that perform clinical assessments and supply legally.

Additional aspects about Viagra