Sildenafil

Overcome erectile dysfunction with prescription Sildenafil (generic Viagra)

Erectile dysfunction, or ED,  is the inability to achieve or maintain an erection suitable for satisfactory sexual intercourse. It is a common type of male sexual dysfunction, affecting more than 150 million men worldwide. Although erectile dysfunction is more common in older men, it can raise its head at any point during a man’s life. Oral medication is the most common form of treatment for ED. Sildenafil is a medication that is used to treat ED.

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20 tablets25mg$36.00
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30 tablets50mg$45.00
60 tablets50mg$90.00
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Information

Written by Patrick Moser, FNP-BC

Information last reviewed 06/21/19

About

What is Sildenafil?

Sildenafil is a prescription medication in the class PDE5 inhibitor. Commonly known as Viagra, is one of the most frequently prescribed oral medications for treatment of erectile dysfunction. It comes in 25, 50, and 100 mg tablets. Sildenafil is also available as a 20 mg tablet; known as Revatio, it is generally used to treat pulmonary hypertension.

How does Sildenafil work?

Sexual stimulation causes release of nitric oxide (NO) into the corpus cavernosum of the penis, which increases blood flow into the penis and causes an erection. In a man with ED, this process is interrupted by a chemical called phosphodiesterase type 5 (PDE5). Sildenafil works by blocking the effects of PDE5 and allows the process to continue uninterrupted. Put simply, Sildenafil increases the amount of blood flow into the penis to achieve erection when a man is sexually stimulated.

How effective is Sildenafil?

Several studies have proven that use of sildenafil results in successful completion of sexual intercourse for 60 to 80 percent of men with ED. There are other treatment options available for those who do not respond to sildenafil.

Ingredients

Active ingredients

The active ingredient in each Sildenafil pill is sildenafil citrate. Sildenafil citrate may be included in the following quantities, depending upon the pill strength selected: 25mg, 50mg,100 mg.

Inactive ingredients

The inactive ingredients in Sildenafil include cellulose, calcium phosphate, magnesium stearate, silicon dioxide, hydroxypropyl cellulose, polyethylene glycol, titanium dioxide, and artificial colors.

Please note: The inactive ingredients may vary between different manufacturers of generic medications.

Dosage

Sildenafil Dosage

Sildenafil comes in 25, 50, or 100 mg tablets. Most men require 50 mg or 100 mg to achieve the desired results. However, some men respond appropriately to the 25 mg dose. Many providers will prescribe 25 or 50 mg initially, then titrate up as needed, to a maximum dose of 100 mg daily.

How to take Sildenafil

Sildenafil should be taken approximately 1 hour before sexual activity. However, Sildenafil has been effective within 30 minutes or up to 4 hours after it is taken. The timing of the effects can vary depending on the individual’s response to treatment.

How often can Sildenafil be taken?

When used as a treatment for ED, Sildenafil should not be taken more than once a day. Although it can be taken daily, it is generally prescribed to be used as needed only before sexual intercourse.

Side Effects

Side Effects

People who take Sildenafil may experience the following mild to moderate side effects:

  • Headaches
  • Flushing
  • Heartburn or indigestion
  • Dizziness
  • Back pain
  • Muscle aches
  • Nausea or vomiting
  • Vision changes, to include blurred vision
  • Sensitivity to light

More serious side effects can include:

  • Heart attack
  • Stroke
  • Sudden cardiac death
  • Intracranial hemorrhage, or bleeding inside of the skull
  • Pulmonary hemorrhage, or bleeding in the lungs
  • Hypertension, or high blood pressure
  • Hypotension, or low blood pressure
  • A prolonged erection lasting more than 4 hours

Contraindications

You should not take Sildenafil if you:

  • Are prescribed nitrates
  • Are taking a medication known as a GC stimulator, such as Riociguat
  • Have a known sensitivity to Sildenafil or any components of the medication

Drug interactions

Sildenafil can interact with some other medications, causing increased or decreased effects of either medication. Some of these drugs are:

  • Nitrates
  • Alpha-blockers
  • Amlodipine
  • Ritonavir and other CYP3A4 inhibitors
  • Erythromycin
  • Ketoconazole
  • St. John’s wort

You should not take Sildenafil if you have been drinking alcohol. Always make sure to tell your doctor what other medications you are taking before starting Sildenafil.

Treatment Options

Treatment Options

There are several different options for treating erectile dysfunction. In addition to Sildenafil, there are other medications such as Cialis or Levitra. Another option may be to use a mechanical device, such as vacuum devices and penile implants. There is also a medication called Alprostadil that can be injected into the penis to help achieve an erection.

Sildenafil vs Cialis

Cialis (Taladafil) is also a popular medication for treatment of erectile dysfunction. Cialis works on the same mechanism of action as Sildenafil. It also has similar side effects and contraindications. The biggest difference between Cialis and Sildenafil is the amount of time the medication is effective. While the effects of Sildenafil last about 4 hours, Cialis can last almost 36 hours before the effects wear off. Sildenafil has been reported to have a slightly higher, approximately 3 percent, satisfaction rate compared to Cialis, and Cialis is much more expensive than Sildenafil. For the price, Sildenafil looks like a pretty good option.

What about testosterone replacement therapy?

One of the actions of Testosterone, a hormone produced in the testicles, is the maintenance of sexual function. Although low Testosterone levels do not cause erectile dysfunction, there is evidence to suggest that Testosterone replacement therapy can improve the problem. Transdermal Testosterone replacement, or replacement of Testosterone using a topical gel that absorbs into the skin, is more effective than getting Testosterone injections or taking an oral Testosterone supplement. Although the replacement of Testosterone can be helpful in the treatment of erectile dysfunction, combining it with Sildenafil does not increase the effects of the medication.

Q&A

Disclaimer: This is not medical advice. You and your physician will determine if and how you should take any medication prescribed to you following a medical consultation.

  1. “Cialis vs Viagra - What's the Difference between Them?” (Drugs.com) <https://www.drugs.com/medical-answers/viagra-vs-cialis-3029937/> accessed June 5, 2019 
  2. “DailyMed - SILDENAFIL CITRATE - Sildenafil Tablet, Film Coated” (U.S. National Library of Medicine) <https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2ccc6fa6-f8ae-4191-806f-a887244e516a#section-11.1> accessed June 4, 2019 
  3. “Effect of Testosterone on Response to Sildenafil in Men With Erectile Dysfunction” (2012) 157 Annals of Internal Medicine 
  4. Konstantinos and Hatzimouratidis, “Sildenafil in the Treatment of Erectile Dysfunction: an Overview of the Clinical Evidence” (2006) 1 Clinical Interventions in Aging 403 
  5. “Sildenafil: MedlinePlus Drug Information” (MedlinePlus) <https://medlineplus.gov/druginfo/meds/a699015.html#special-dietary> accessed June 4, 2019 
  6. “WebMD Erectile Dysfunction Health Center - Find Impotence Information and Latest News on ED Treatments.” (WebMD) <https://www.webmd.com/erectile-dysfunction/default.htm> accessed June 4, 2019

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