Sildenafil

Sildenafil is the active ingredient originally developed by Pfizer and marketed as Viagra. Now widely available as a generic medication, it offers the same proven efficacy at a more accessible price point. As a PDE5 inhibitor, sildenafil enhances the natural erectile response by preventing the breakdown of cyclic GMP, a molecule that relaxes smooth muscle and promotes blood flow to the penis during sexual arousal.

Sildenafil is effective across a broad range of erectile dysfunction causes, whether the origin is psychological, vascular, neurological, or a combination. It is important to understand that sexual stimulation is still necessary for the medication to work; sildenafil does not produce spontaneous erections.

How to Take Sildenafil

Take one tablet approximately one hour before sexual activity. Swallow it whole with a glass of water. Sildenafil can be taken with or without food, though a heavy or high-fat meal may delay its onset of action by up to an hour. The effects typically last four to six hours, during which an erection can be achieved with sexual stimulation. Do not take more than one dose in any 24-hour period.

The recommended starting dose is 50 mg, taken as needed. Based on how well it works and how well you tolerate it, your prescriber may increase the dose to 100 mg or reduce it to 25 mg. Elderly patients, and those with significant kidney or liver impairment, usually start at 25 mg. The maximum dose is 100 mg, taken no more than once daily.

Common Side Effects

The most frequently reported side effects include:

• Headache
• Facial flushing
• Indigestion
• Nasal congestion
• Dizziness
• A temporary blue tinge to vision

Less common effects include palpitations, nausea, and muscle aches. Rarely, sildenafil has been associated with priapism (a prolonged, painful erection lasting more than four hours), sudden hearing loss, and non-arteritic anterior ischaemic optic neuropathy (NAION). Seek emergency medical care if you experience any of these serious effects.

Sildenafil must never be combined with nitrate medications or recreational nitrates (poppers), as this can cause a severe and potentially fatal drop in blood pressure. Use with caution if you have cardiovascular disease, and discuss your suitability with your prescriber before use if you have had a recent heart attack or stroke.

Seek immediate medical attention for an erection lasting longer than four hours, as untreated priapism can cause permanent damage to the penile tissue.

Do not take sildenafil if you use nitrates in any form, guanylate cyclase stimulators such as riociguat, or if you have a severe cardiovascular condition where sexual activity is medically inadvisable. It is also contraindicated in patients who have experienced a stroke or heart attack within the past six months, those with severe low blood pressure, and individuals with known hereditary degenerative retinal disorders such as retinitis pigmentosa.