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, you will probably take sildenafil three times a day with or without food. Take sildenafil at around the same times every day.
Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.
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.
| Age Range | Lowest Effective Dose | Typical Dose | Max Dose | Notes |
|---|---|---|---|---|
| 18-40 | 50mg | 50-100mg | 100mg | Start with lower dose if sensitive |
| 41-60 | 50mg or 100mg | 50-100mg | 100mg | Adjust based on response |
| 61+ | 25mg or 50mg | 25mg or 50mg | 100mg | Caution with higher doses |
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.
| Myth | Reality | Evidence or Explanation | Notes |
|---|---|---|---|
| Viagra works instantly after taking it | Onset time is about 30-60 minutes | Depends on individual and food intake | Take in advance of activity |
| Higher dose is always better | Not necessarily, can cause more side effects | Start low and adjust under medical supervision | 50mg is typical starting dose |
| Viagra causes permanent erections | No, effects last only temporarily | Temporary enhancement during medication influence | Safe if used as prescribed |
| Viagra can be used by women | No, it is formulated for men | Different medication, safety, and efficacy for women | Use only as directed by doctor |
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. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Vacuum therapy in erectile dysfunction—Science and clinical evidence. International Journal of Impotence Research, 22(4), 211-219. The science of vacuum erectile device in penile rehabilitation after radical prostatectomy. Translational Andrology and Urology, 2(1), 61–66. The role of vacuum pump therapy to mechanically straighten the penis in Peyronie’s disease.
Maca (L. meyenii) for improving sexual function: a systematic review. BMC Complementary and Alternative Medicine, 10, 44. Effect of Tongkat Ali on stress hormones and psychological mood state in moderately stressed subjects. Journal of the International Society of Sports Nutrition, 10(1), 28.
An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. A Randomized, Double-Blind, Placebo-Controlled, Crossover Study Examining the Hormonal and Vitality Effects of Ashwagandha ( Withania somnifera) in Aging, Overweight Males. American Journal of Men's Health, 13(2), 1557988319835985. Effect of standardized root extract of ashwagandha (Withania somnifera) on well-being and sexual performance in adult males: A randomized controlled trial. Subjective effects of Lepidium meyenii (Maca) viagra alternative uk extract on well-being and sexual performances in patients with mild erectile dysfunction: a randomised, double-blind clinical trial. tell your doctor and pharmacist if you are allergic to sildenafil, any other medications, or any of the ingredients in sildenafil tablet or suspension.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Viagra Generic | 200mg | 30 + 2 Pills | 83.07€ 79.11€ | |
| Viagra Generic | 100mg | 60 + 4 Pills | 96.36€ 91.77€ | |
| Viagra Generic | 25mg | 90 + 6 Pills | 105.03€ 100.03€ | |
| Viagra Generic | 25mg | 180 + 6 Pills | 154.93€ 147.55€ | |
| Viagra Super Active | 100mg | 10 Pills | 28.76€ 27.39€ | |
| Viagra Generic | 150mg | 20 Pills | 55.02€ 52.40€ | |
| Viagra Generic | 25mg | 20 Pills | 37.74€ 35.94€ | |
| Viagra Oral Jelly | 100mg | 110 + 9 Sachets | 284.63€ 271.08€ | |
| Viagra Generic | 50mg | 180 + 8 Pills | 158.82€ 151.26€ | |
| Viagra Professional | 100mg | 90 + 2 Pills | 207.09€ 197.23€ | |
| Viagra Soft Tabs | 100mg | 10 Pills | 36.93€ 35.17€ | |
| Viagra Oral Jelly | 100mg | 21 Sachets | 78.66€ 74.91€ | |
| Viagra Oral Jelly | 100mg | 220 + 18 Sachets | 562.28€ 535.50€ | |
| Viagra Soft Tabs | 100mg | 120 + 8 Pills | 232.21€ 221.15€ | |
| Viagra Super Active | 100mg | 90 + 10 Pills | 165.61€ 157.72€ | |
| Viagra Generic | 150mg | 90 + 6 Pills | 147.18€ 140.17€ |
Ask your pharmacist for a list of the ingredients.
| Country | Prescription Needed | Over-the-counter Sales Allowed | Online Sales Restrictions | Notes |
|---|---|---|---|---|
| USA | Yes | No | Strict regulation | Prescription mandatory for all brands |
| UK | Yes | No | Strict online regulation | Prescription required, licensed pharmacies only |
| India | No | Yes (online) | Looser regulation | Still recommend consultation before use |
| Australia | Yes | No | Online restrictions apply | Prescription compulsory in most states |
Some medications should not be taken with sildenafil.
Avanafil for treatment of erectile dysfunction: review of its potential. Vascular Health and Risk Management, 8, 517-523. Cross-Study Review of the Clinical Efficacy of Apomorphine SL 2 and 3 mg: Pooled Data from Three Placebo-Controlled, Fixed-Dose Crossover Studies. European Urology Supplements, 1(3), 12-20. Apomorphine: an update of clinical trial results.
International Journal of Impotence Research, 12 Suppl 4, S67–S73. A single-centre result of two courses of low-intensity shockwave therapy (Li-SWT) in erectile dysfunction. Effect of oral administration of high-dose nitric oxide donor L-arginine in men with organic erectile dysfunction: results of a double-blind, randomized, placebo-controlled study. Treatment of erectile dysfunction with pycnogenol and L-arginine. Journal of Sex & Marital Therapy, 29(3), 207–213.
Red ginseng for treating erectile dysfunction: a systematic review. British Journal of Clinical Pharmacology, 66(4), 444-450. The World Journal of Men's Health, 36(3), 183-191. Efficacy and safety of long-term tadalafil 5 mg once daily combined with sildenafil 50 mg as needed at the early stage of treatment for patients with erectile dysfunction. Phosphodiesterase-5 (PDE5) Inhibitors In the Management of Erectile Dysfunction. Make sure you have discussed any other medications you are currently taking or plan to take before starting sildenafil with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking sildenafil, please get the advice of your doctor or pharmacist. tell your doctor if you are taking street drugs containing nitrates ('poppers') such as amyl nitrate, amyl nitrite, or butyl nitrate while taking sildenafil.
Your doctor will tell you not to take sildenafil if you are taking street drugs containing nitrates. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take.
Comprehensive Intersystemic Assessment Approach to Relieve Psychogenic Erectile Dysfunction: A Review. Open Access Macedonian Journal of Medical Sciences, 9(F), 189–196. Erectogenic and neurotrophic effects of icariin, a purified extract of horny goat weed (Epimedium spp.) in vitro and in vivo. The Journal of Sexual Medicine, 7(4 Pt 1), 1518–1528. Oxytocin in the Treatment of Psychiatric Disorders.
Efficacy and safety of fixed-dose oral sildenafil in the treatment of erectile dysfunction of various etiologies. Efficacy and safety of avanafil for treating erectile dysfunction: results of a multicentre, randomized, double-blind, placebo-controlled trial. Sildenafil (Viagra) is used to treat erectile dysfunction (impotence; inability to get or keep an erection) in men. Sildenafil (Liqrev, Revatio) is used to improve the ability to exercise in adults (Liqrev, Revatio) and children 1 year of age and older (Revatio) with pulmonary arterial hypertension (PAH; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness). 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. If you are taking sildenafil to treat erectile dysfunction, you should know that it does not cure erectile dysfunction or increase sexual desire. Sildenafil does not prevent pregnancy or the spread of sexually transmitted diseases such as human immunodeficiency virus (HIV). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. you should know that sildenafil is available under the brand names Liqrev, Revatio, and Viagra. You should only be treated with one of these products at a time.
The Efficacy and Safety of Avanafil During a Treatment of Male Erectile Dysfunction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Therapeutics and Clinical Risk Management, 19, 629-644. The efficacy of fluoxetine in the treatment of premature ejaculation: a double-blind placebo controlled study. The Journal of Urology, 156(5), 1631–1632. Relative Efficacy of Minoxidil and the 5-α Reductase Inhibitors in Androgenetic Alopecia Treatment of Male Patients: A Network Meta-analysis.
Atorvastatin efficacy in the primary and secondary prevention of cardiovascular events. Trends in Urology & Men's Health, 12(6), 19-22. Psychological Factors Related to Impotence as a Sexual Dysfunction in Young Men: A Literature Scan for Noteworthy Research Frameworks. Clinics and Practice, 12(4), 501-512. The role of cortisol in erectile function.
Translational Andrology and Urology, 12(8), 1213-1214. People who Expect to Enter Psychotherapy are Prone to Believing that They Have Forgotten Memories of Childhood Trauma and Abuse. Mental Health Medications, U.S. Department of Health and Human Services. Penile Entrapment With Thick Penile Ring: A Case Report and Literature Review. The following nonprescription or herbal products may interact with sildenafil: cimetidine (Tagamet HB), St. John's wort.
Sildenafil comes as a tablet and suspension (liquid) 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. Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking sildenafil. Do not start these medications while taking sildenafil without discussing it with your healthcare provider. tell your doctor if you smoke, if you have had heart surgery within the last 6 months, if you have ever had an erection that lasted for more than 4 hours, and if you have recently lost a large amount of body fluids (dehydration). This can happen if you are sick with fever, diarrhea, or vomiting; sweat a lot; or do not drink enough liquids. Also tell your doctor if you have or have ever had pulmonary veno-occlusive disease (PVOD; blockage of veins in the lungs); a stomach ulcer; heart, kidney, or liver disease; a heart attack; heart failure; angina (chest pain); an irregular heartbeat; a stroke; chest pain; high or low blood pressure; high cholesterol; a bleeding disorder; blood circulation problems; blood cell problems such as sickle cell anemia (a disease of the red blood cells), multiple myeloma (cancer of the plasma cells), or leukemia (cancer of the white blood cells); conditions affecting the shape of the penis (e.g., angulation, cavernosal fibrosis, or Peyronie's disease); or diabetes.