What Is Viagra: How To Use, Side Effects, Doses, When To Take

What Is Viagra: How To Use, Side Effects, Doses, When To Take

This article about Viagra (Sildenafil, Revatio) with Full Information that all of information has been updated in 2019. This article about Viagra (Sildenafil, Revatio) include high effective research that after this place you dont need for another place to get more information about Viagra (Sildenafil, Revatio) because with Healthyol you can get full information for free with free advise for you in comments.
so titles about Viagra (Sildenafil, Revatio) include 31 titles that you will read: 

  1. Viagra Meaning 
  2. What is Viagra
  3. What Does Viagra Do 
  4. Price of Viagra
  5. How to buy Viagra
  6. Generic Vigara
  7. Viagra uses (Viagra for erectile dysfunction)
  8. Viagra online (Online Viagra)
  9. Mechanism of Action Viagra
  10. Viagra Without Prescription
  11. How To Use Viagra
  12. How Does Viagra Work
  13. Viagra Effects
  14. Effects of VIAGRA on Blood Pressure
  15. Alternatives To Viagra
  16. How should I take Viagra
  17. Viagra Overdose 
  18. When To Take Viagra
  19. What Are The Side Effects Of Viagra
  20. Viagra Doses
  21. Dosage of Viagra 
  22. What other drugs will affect Viagra
  23. Tadalafil 20mg
  24. Viagra 25 mg
  25. Viagra 50 mg
  26. Viagra100 mg
  27. Sildenafil 100 mg
  28. How Long Does Viagra Last 
  29. For whom Viagra might not be safe
  30. Viagra while pregnancy
  31. Warnings of Viagra

Viagra Meaning

Viagra is a medicine that relaxes muscles found in the walls of blood vessels and increases blood flow to particular areas of the body. In order to treat erectile dysfunction your doctor may recommend you to use Viagra pills. Here is some information about Viagra and its mechanism on your body, its dosage. Along with its needed effects, some unwanted effects are mentioned too.

Viagra is used to treat erectile dysfunction (impotence) in men. Another brand of sildenafil is Revatio, which is used to treat high blood pressure in the pulmonary artery and improve exercises in men and women. VIAGRA (sildenafil citrate), an oral therapy for erectile dysfunction, is the citrate salt of sildenafil, a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5).

Please if you have any questions about Viagra and Erectile Dysfunction, you can ask us by commenting below this text, we'll answer you as soon as possible.

What is Viagra

Viagra (sildenafil) finds muscle in the blood vessel wall and increases blood flow to specific areas of the body. Sildenafil is used to treat male sexual dysfunction (impotence or erectile dysfunction). Combined with sexual stimulation, sildenafil works by increasing the blood flow to the penis to help a man and maintain an erection. Practice "healthy sex" like using latex condoms. Consult your doctor or pharmacist for details. (Viagra Without Prescription)

It does not protect against sexually transmitted diseases (such as HIV, hepatitis B, gonorrhea, syphilis).

It does not protect against sexually transmitted diseases (such as HIV, hepatitis B, gonorrhea, syphilis).

VIAGRA (sildenafil citrate) helps a man with erectile dysfunction get and keep an erection only when he is sexually excited (stimulated).

VIAGRA is not for use in women or children.

It is not known if VIAGRA is safe and effective in women or children under 18 years of age.

Keywords: Viagra, Sildenafil, Erectile dysfunction, Side effects, Dosing information, Revatio

What Does Viagra Do

Viagra is used to treat erectile dysfunction (ED) in men. Another brand of sildenafil is Revatio, which is used to treat pulmonary arterial hypertension and reclaim exercise capacity in both genders. 

Sildenafil (Viagra, Revatio) is a moderately priced drug used to treat erection problems in men. It is also used to treat pulmonary arterial hypertension, a serious heart and lung condition. This drug is more popular than comparable drugs. It is available in generic and brand versions.(Read full information about Generic Viagra: Generic Viagra) Generic sildenafil is covered by most Medicare and insurance plans, but some pharmacy coupons or cash prices may be lower. The lowest GoodRx price for the most common version of sildenafil is around $5.83, 87% off the average retail price of$47.43. (Read full information about Price of Viagra: Price of Viagra and also How to buy Viagra?) 

VIAGRA does not cure erectile dysfunction. It is a treatment for erectile dysfunction. VIAGRA does not protect you or your partner from getting sexually transmitted diseases, including HIV—the virus that causes AIDS. VIAGRA is not a hormone or an aphrodisiac.

Mechanism of Action Viagra

The physiologic mechanism of erection of the penis involves release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. NO then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate (cGMP), producing smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood.

Sildenafil has no direct relaxant effect on isolated human corpus cavernosum, but enhances the effect of nitric oxide (NO) by inhibiting phosphodiesterase type 5 (PDE5), which is responsible for degradation of cGMP in the corpus cavernosum.

When sexual stimulation causes local release of NO, inhibition of PDE5 by sildenafil causes increased levels of cGMP in the corpus cavernosum, resulting in smooth muscle relaxation and inflow of blood to the corpus cavernosum. Sildenafil at recommended doses has no effect in the absence of sexual stimulation. 
Studies in vitro have shown that sildenafil is selective for PDE5. Its effect is more potent on PDE5 than on other known phosphodiesterases (10-fold for PDE6, > 80-fold for PDE1, > 700-fold for PDE2, PDE3, PDE4, PDE7, PDE8, PDE9, PDE10, and PDE11). Sildenafil is approximately 4,000-fold more selective for PDE5 compared to PDE3. PDE3 is involved in control of cardiac contractility. Sildenafil is only about 10-fold as potent for PDE5 compared to PDE6, an enzyme found in the retina which is involved in the phototransduction pathway of the retina. This lower selectivity is thought to be the basis for abnormalities related to color vision.

In addition to human corpus cavernosum smooth muscle, PDE5 is also found in other tissues including platelets, vascular and visceral smooth muscle, and skeletal muscle, brain, heart, liver, kidney, lung, pancreas, prostate, bladder, testis, and seminal vesicle. The inhibition of PDE5 in some of these tissues by sildenafil may be the basis for the enhanced platelet antiaggregatory activity of NO observed in vitro, an inhibition of platelet thrombus formation in vivo and peripheral arterial-venous dilatation in vivo.

How To Use Viagra

Viagra usually takes 30 minutes to 1 hour before sexual activity when needed. Viagra can help you stimulate sexual stimulation. An erection is not caused by just taking a pill. Follow your doctor's instructions. To cure erectile dysfunction-ED, take this drug by mouth as prescribed by your doctor, usually as needed. A high-fat meal may delay how quickly the drug begins to work.

You can take it up to 4 hours before sexual activity. Do not use Viagra more than once a day.

Read the Patient Information Leaflet provided by your pharmacist before you start taking sildenafil and each time you get a refill. If you have any questions, ask your doctor or pharmacist or you can write comments to us for help. 

A high-fat meal may delay how quickly the drug begins to work.

The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use including prescription drugs, nonprescription drugs, and herbal products.

If you are taking sildenafil to treat PAH, follow your doctor's directions and the guidelines in this paragraph. You will probably take sildenafil three times a day with or without food. Take sildenafil at around the same times every day, and space your doses about 4 to 6 hours apart.

how does Viagra work

Please if you have any questions about Viagra and Erectile Dysfunction, you can ask us by commenting below this text, we'll answer you as soon as possible.

How Does Viagra Work 

The physiologic mechanism of erection of the penis involves release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. NO then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate (cGMP), producing smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood.

Sildenafil has no direct relaxant effect on isolated human corpus cavernosum, but enhances the effect of nitric oxide (NO) by inhibiting phosphodiesterase type 5 (PDE5), which is responsible for degradation of cGMP in the corpus cavernosum. When sexual stimulation causes local release of NO, inhibition of PDE5 by sildenafil causes increased levels of cGMP in the corpus cavernosum, resulting in smooth muscle relaxation and inflow of blood to the corpus cavernosum. Sildenafil at recommended doses has no effect in the absence of sexual stimulation. 

Viagra does not cause a man to be sexually aroused. Viagra is only effective if you are sexually aroused. To understand how it works you need to understand the mechanics of how a man gets an erection. When you get sexually stimulated, the nervous system in the erectile tissue of your penis releases nitric oxide (NO).

The nitric oxide stimulates an enzyme that produces something called a messenger cyclic guanosine monophosphate (cGMP). The cGMP relaxes the smooth muscle cells. One result of this is that the arteries in your penis dilate and the blood can flow into your penis more easily. Another result is that the erectile tissue itself fills with blood. Both of these process result in an erection. Viagra works by maintaining the level of cGMP in the smooth muscle cells.
If you are not turned on, your brain will not stimulate the release of any nitric oxide and you will not produce any cGMP.

Viagra Effects

Some remedies can cause unwanted or dangerous effects when used with Viagra. Do not take Viagra if you are using a nitrate drug for chest pain or heart problems, including nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, and some recreational drugs such as "poppers". Using sildenafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure.

You should not use Viagra if you are allergic to sildenafil, or:

if you take other medicines to treat pulmonary arterial hypertension, such as riociguat (Adempas).

Do not take Viagra if you are also using a nitrate drug for chest pain or heart problems. This includes nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers"). Taking Viagra with a nitrate medicine can cause a sudden and serious decrease in blood pressure.

To make sure Viagra is safe for you, tell your doctor if you have ever had:

  • heart disease or heart rhythm problems, coronary artery disease;
  • a heart attack, stroke, or congestive heart failure;
  • high or low blood pressure;
  • liver or kidney disease;
  • a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia;
  • a bleeding disorder such as hemophilia;
  • a stomach ulcer;  
  • retinitis pigmentosa (an inherited condition of the eye);
  • a physical deformity of the penis (such as Peronei’s disease); or
  • if you have been told you should not have sexual intercourse for health reasons.

Viagra can decrease blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking sildenafil, most of whom also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoked or were over 50 years old. It is not clear whether sildenafil is the actual cause of vision loss.

Viagra is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

it is not known whether sildenafil passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Do not give Viagra to anyone under 18 years old without medical advice.
an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, get medical help right away. If it is not treated right away, priapism can permanently damage your penis.

sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). Stop taking VIAGRA and call your healthcare provider right away if you have sudden vision loss in one or both eyes.

sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness. If you have these symptoms, stop taking VIAGRA and contact a doctor right away.

Effects of VIAGRA on Blood Pressure:

Single oral doses of sildenafil (100 mg) administered to healthy volunteers produced decreases in sitting blood pressure (mean maximum decrease in systolic/diastolic blood pressure of 8.3/5.3 mmHg). The decrease in sitting blood pressure was most notable approximately 1-2 hours after dosing, and was not different than placebo at 8 hours. Similar effects on blood pressure were noted with 25 mg, 50 mg and 100 mg of VIAGRA, therefore the effects are not related to dose or plasma levels within this dosage range. Larger effects were recorded among patients receiving concomitant nitrates. (Read full information about Alternatives to Viagra: Alternatives To Viagra)

The following events occurred in < 2% of patients in controlled clinical trials; a causal relationship to VIAGRA is uncertain. Reported events include those with a plausible relation to drug use; omitted are minor events and reports too imprecise to be meaningful:

Body as a Whole

face edema, photosensitivity reaction, shock, asthenia, pain, chills, accidental fall, abdominal pain, allergic reaction, chest pain, accidental injury.
Cardiovascular: angina pectoris, AV block, migraine, syncope, tachycardia, palpitation, hypotension, postural hypotension, myocardial ischemia, cerebral thrombosis, cardiac arrest, heart failure, abnormal electrocardiogram, cardiomyopathy.

Digestive

vomiting, glossitis, colitis, dysphagia, gastritis, gastroenteritis, esophagitis, stomatitis, dry mouth, liver function tests abnormal, rectal hemorrhage, gingivitis.
Hemic and Lymphatic: anemia and leukopenia.


Metabolic and Nutritional

thirst, edema, gout, unstable diabetes, hyperglycemia, peripheral edema, hyperuricemia, hypoglycemic reaction, hypernatremia.

Musculoskeletal

arthritis, arthrosis, myalgia, tendon rupture, tenosynovitis, bone pain, myasthenia, synovitis.

Nervous

ataxia, hypertonia, neuralgia, neuropathy, paresthesia, tremor, vertigo, depression, insomnia, somnolence, abnormal dreams, reflexes decreased, hypesthesia.

Respiratory

asthma, dyspnea, laryngitis, pharyngitis, sinusitis, bronchitis, sputum increased, cough increased.

Skin and Appendages

urticaria, herpes simplex, pruritus, sweating, skin ulcer, contact dermatitis, exfoliative dermatitis.

Special Senses

sudden decrease or loss of hearing, mydriasis, conjunctivitis, photophobia, tinnitus, eye pain, ear pain, eye hemorrhage, cataract, dry eyes.

Urogenital

cystitis, nocturia, urinary frequency, breast enlargement, urinary incontinence, abnormal ejaculation, genital edema and anorgasmia.

Analysis of the safety database from controlled clinical trials showed no apparent difference in adverse reactions in patients taking VIAGRA with and without anti-hypertensive medication. This analysis was performed retrospectively, and was not powered to detect any pre-specified difference in adverse reactions.

Postmarketing Experience

The following adverse reactions have been identified during post approval use of VIAGRA. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. These events have been chosen for inclusion either due to their seriousness, reporting frequency, lack of clear alternative causation, or a combination of these factors.

Cardiovascular and Cerebrovascular

Serious cardiovascular, cerebrovascular, and vascular events, including myocardial infarction, sudden cardiac death, ventricular arrhythmia, cerebrovascular hemorrhage, transient ischemic attack, hypertension, subarachnoid and intracerebral hemorrhages, and pulmonary hemorrhage have been reported post-marketing in temporal association with the use of VIAGRA. Most, but not all, of these patients had preexisting cardiovascular risk factors. Many of these events were reported to occur during or shortly after sexual activity, and a few were reported to occur shortly after the use of VIAGRA without sexual activity. Others were reported to have occurred hours to days after the use of VIAGRA and sexual activity. It is not possible to determine whether these events are related directly to VIAGRA, to sexual activity, to the patient's underlying cardiovascular disease, to a combination of these factors, or to other factors.

Hemic and Lymphatic

vaso-occlusive crisis: In a small, prematurely terminated study of REVATIO (sildenafil) in patients with pulmonary arterial hypertension (PAH) secondary to sickle cell disease, vaso-occlusive crises requiring hospitalization were more commonly reported in patients who received sildenafil than in those randomized to placebo. The clinical relevance of this finding to men treated with VIAGRA for ED is not known.

Nervous: seizure, seizure recurrence, anxiety, and transient global amnesia.

Hearing

Cases of sudden decrease or loss of hearing have been reported postmarketing in temporal association with the use of PDE5 inhibitors, including VIAGRA. In some of the cases, medical conditions and other factors were reported that may have also played a role in the otologic adverse events. In many cases, medical follow-up information was limited. It is not possible to determine whether these reported events are related directly to the use of VIAGRA, to the patient's underlying risk factors for hearing loss, a combination of these factors, or to other factors.

Ocular

diplopia, temporary vision loss/decreased vision, ocular redness or bloodshot appearance, ocular burning, ocular swelling/pressure, increased intraocular pressure, retinal edema, retinal vascular disease or bleeding, and vitreous traction/detachment.

Non-arteritic anterior ischemic optic neuropathy (NAION), a cause of decreased vision including permanent loss of vision, has been reported rarely post-marketing in temporal association with the use of phosphodiesterase type 5 (PDE5) inhibitors, including VIAGRA. Most, but not all, of these patients had underlying anatomic or vascular risk factors for developing NAION, including but not necessarily limited to: low cup to disc ratio (“crowded disc”), age over 50, diabetes, hypertension, coronary artery disease, hyperlipidemia and smoking. It is not possible to determine whether these events are related directly to the use of PDE5 inhibitors, to the patient's underlying vascular risk factors or anatomical defects, to a combination of these factors, or to other factors.

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.

VIAGRA was administered to over 3700 patients (aged 19-87 years) during pre-marketing clinical trials worldwide. Over 550 patients were treated for longer than one year.

In placebo-controlled clinical studies, the discontinuation rate due to adverse reactions for VIAGRA (2.5%) was not significantly different from placebo (2.3%).

In fixed-dose studies, the incidence of some adverse reactions increased with dose. The type of adverse reactions in flexible-dose studies, which reflect the recommended dosage regimen, was similar to that for fixed-dose studies. At doses above the recommended dose range, adverse reactions were similar to those detailed in Table 1 below but generally were reported more frequently.

How should I take Viagra?

Take Viagra exactly as it was prescribed for you. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Viagra is usually taken only when needed, 30 minutes to 1 hour before sexual activity. You may take it up to 4 hours before sexual activity. Do not take Viagra more than once per day.

Viagra can help you have an erection when sexual stimulation occurs. An erection will not occur just by taking a pill. Follow your doctor's instructions.
During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect of Viagra.

Store at room temperature away from moisture and heat.

Viagra Overdose 

Seek emergency medical attention or call the Poison Help line.

When To Take Viagra?

Drinking alcohol with this medicine can cause side effects.

Grapefruit and grapefruit juice may interact with sildenafil and lead to unwanted side effects. Avoid the use of grapefruit products while taking Viagra.

Avoid using any other medicines to treat impotence, such as alprostadil or yohimbine, without first talking to your doctor.

What Are The Side Effects Of Viagra?

Single oral doses of sildenafil (100 mg) administered to healthy volunteers produced decreases in sitting blood pressure (mean maximum decrease in systolic/diastolic blood pressure of 8.3/5.3 mmHg). The decrease in sitting blood pressure was most notable approximately 1-2 hours after dosing, and was not different than placebo at 8 hours. Similar effects on blood pressure were noted with 25 mg, 50 mg and 100 mg of VIAGRA, therefore the effects are not related to dose or plasma levels within this dosage range. Larger effects were recorded among patients receiving concomitant nitrates. (Read full information about Side effects of Viagra: Side effects of Viagra)

Side Effects of Viagra

Please if you have any questions about Viagra and Erectile Dysfunction, you can ask us by commenting below this text, we'll answer you as soon as possible.

Viagra Side Effects

Get emergency medical help if you have signs of an allergic reaction to Viagra: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Do not take Viagra while also taking Revatio, unless your doctor recommends you.

Stop taking Viagra and get emergency medical help if you have:

  • heart attack symptoms--chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;
  • vision changes or sudden vision loss; or
  • erection is painful or lasts longer than 4 hours (prolonged erection can damage the penis).

Call your doctor at once if you have:

  • ringing in your ears, or sudden hearing loss;
  • irregular heartbeat;
  • swelling in your hands, ankles, or feet;
  • shortness of breath;
  • seizure (convulsions); or
  • a light-headed feeling, like you might pass out.

Less Common

  • Bladder pain
  • burning feeling in the chest or stomach
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • cloudy or bloody urine  • dizziness  • increased frequency of urination
  • indigestion
  • pain on urination
  • stomach upset
  • tenderness in the stomach area

Rare

  • Abnormal vision
  • anxiety
  • behavior change similar to drunkenness
  • bleeding of the eye  • blurred vision
  • bone pain, breast enlargement
  • chest pain
  • chills
  • cold sweats
  • confusion
  • convulsions (seizures)
  • cool and pale skin
  • deafness or hearing loss
  • decrease in amount of urine or the frequency of urination
  • decreased vision
  • difficulty in concentrating
  • dizziness or lightheadedness, especially when getting up suddenly from a lying or sitting position
  • double vision
  • drowsiness
  • dry eyes
  • dry mouth
  • dryness, redness, scaling, or peeling of the skin
  • excessive hunger
  • eye pain
  • fainting or faintness
  • fast, irregular, or pounding heartbeat
  • feeling of something in the eye
  • fever or chills
  • headache (severe or continuing)
  • increase in the size of the pupil
  • increased sweating
  • increased thirst
  • lower back or side pain
  • migraine headache
  • nausea (severe or continuing)
  • nervousness
  • nightmares
  • numbness of the hands
  • painful, swollen joints
  • prolonged, painful erection of penis
  • redness, burning, or swelling of the eyes
  • redness, itching, or tearing of the eyes
  • restless sleep
  • seeing shades of colors differently than before
  • sensitivity to light
  • shakiness, skin lesions with swelling
  • skin paleness
  • skin rash, hives, or itching
  • skin ulcers
  • slurred speech
  • sore throat
  • sudden weakness
  • swelling of the face, hands, feet, or lower legs
  • trouble breathing
  • twitching of the muscles
  • unusual feeling of burning or stinging of the skin
  • unusual tiredness or weakness
  • vision changes
  • vision loss, temporary

Viagra Doses

Usual Adult Dose for Erectile Dysfunction:Initial dose:

50 mg orally once a day, as needed, 1 hour prior to sexual activity Maintenance: 25 to 100 mg orally once

a day, as needed, 1 hour prior to sexual activity Comments: This drug may be taken anywhere from 30 minutes to 4 hours before sexual activity.  

Usual Geriatric Dose for Erectile Dysfunction:

Initial dose: 25 mg orally once a day 1 hour prior to sexual activity

Dosage of Viagra 

The maximum recommended dose is once a day. Dental settings in special circumstances.

For most patients, the recommended dose is 50 mg, if needed, approximately 1 hour before sexual activity. However, VIAGRA may be taken anywhere from 30 minutes to 4 hours before sexual activity.

Based on effectiveness and toleration, the dose may be increased to a maximum recommended dose of 100 mg or decreased to 25 mg.

Based on effectiveness and toleration, the dose may be increased to a maximum recommended dose of 100 mg or decreased to 25 mg.

It seems that VIAGRA has been shown to inhibit the effects of nitrates, and it is contraindicated in patients who use nitric oxide donors such as organic nitrites or organic nitrites in any form.

Please if you have any questions about Viagra and Erectile Dysfunction, you can ask us by commenting below this text, we'll answer you as soon as possible.

What other drugs will affect Viagra?

Do not take Viagra with similar medications such as avanafil (Stendra), tadalafil (Cialis) or vardenafil (Levitra). Tell your doctor about all other medications you use for erectile dysfunction.

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Tell your doctor about all your current medicines and any you start or stop using, especially:

  • drugs to treat high blood pressure or a prostate disorder;
  • an antibiotic - clarithromycin, erythromycin, or telithromycin;
  • antifungal medicine - ketoconazole or itraconazole; or
  • medicine to treat HIV/AIDS - atazanavir, indinavir, ritonavir, or saquinavir.

This list is not complete. Other drugs may interact with sildenafil, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

How Long Does Viagra Last 

How Long Does Viagra Last 

On average, Viagra usually lasts between two and three hours before its effects start to diminish. Viagra can last up to five hours or longer depending on your dosage, your body’s metabolism, and other external factors.

Depending on how your body metabolizes it, you may be able to get an erection several times with Viagra in your body. Viagra probably won’t make you last longer in bed, though. No research has proven definitively that Viagra can increase how long you can have sex.

Viagra may not work again immediately after you’ve had sex. Normally, you can’t get another erection right after ejaculating because your body isn’t physiologically prepared for it. This is known as the refractory period. It may only last a few minutes, but it can last as long as a few hours or days.

For whom Viagra might not be safe

You should not take Viagra if you are allergic to sildenafil, or:

if you take other drugs to cure pulmonary arterial hypertension, such as riociguat (Adempas).

Do not take Viagra if you are also using a nitrate drug for chest pain or heart problems. This includes nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers"). Taking Viagra with a nitrate medicine can cause a sudden and serious decrease in blood pressure.

To make sure Viagra is safe for you, tell your doctor if you have ever had:

  • liver or kidney disease;
  • heart disease or heart rhythm problems, coronary artery disease;
  • a bleeding disorder such as hemophilia;
  • a heart attack, stroke, or congestive heart failure;
  • high or low blood pressure;
  • a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia;
  • a stomach ulcer;
  • retinitis pigmentosa (an inherited condition of the eye);
  • a physical deformity of the penis (such as Peyronie's disease); or
  • if you have been told you should not have sexual intercourse for health reasons.

Viagra can reduce blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking sildenafil, most of whom also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoked or were over 50 years old. It is not clear whether sildenafil is the actual cause of vision loss.

Viagra while pregnancy

Viagra while pregnancy

Viagra is not expected to harm an unborn baby. Tell your doctor if you are pregnant or want to be pregnant.

Warnings of Viagra

Included as part of the PRECAUTIONS section.

PRECAUTIONS

Cardiovascular

There is a potential for cardiac risk of sexual activity in patients with preexisting cardiovascular disease. Therefore, treatments for erectile dysfunction, including VIAGRA, should not be generally used in men for whom sexual activity is inadvisable because of their underlying cardiovascular status. The evaluation of erectile dysfunction should include a determination of potential underlying causes and the identification of appropriate treatment following a complete medical assessment.

VIAGRA has systemic vasodilatory properties that resulted in transient decreases in supine blood pressure in healthy volunteers (mean maximum decrease of 8.4/5.5 mmHg). While this normally would be expected to be of little consequence in most patients, prior to prescribing VIAGRA, physicians should carefully consider whether their patients with underlying cardiovascular disease could be affected adversely by such vasodilatory effects, especially in combination with sexual activity.

Use with caution in patients with the following underlying conditions which can be particularly sensitive to the actions of vasodilators including VIAGRA – those with left ventricular outflow obstruction (e.g., aortic stenosis, idiopathic hypertrophic subaortic stenosis) and those with severely impaired autonomic control of blood pressure.

There are no controlled clinical data on the safety or efficacy of VIAGRA in the following groups; if prescribed, this should be done with caution.

Patients who have suffered a myocardial infarction, stroke, or life-threatening arrhythmia within the last 6 months;
Patients with resting hypotension (BP < 90/50 mmHg) or hypertension (BP > 170/110 mmHg);
Patients with cardiac failure or coronary artery disease causing unstable angina.
Prolonged Erection And Priapism

Prolonged erection greater than 4 hours and priapism (painful erections greater than 6 hours in duration) have been reported infrequently since market approval of VIAGRA. In the event of an erection that persists longer than 4 hours, the patient should seek immediate medical assistance. If priapism is not treated immediately, penile tissue damage and permanent loss of potency could result.

VIAGRA should be used with caution in patients with anatomical deformation of the penis (such as angulation, cavernosal fibrosis or Peyronie's disease), or in patients who have conditions which may predispose them to priapism (such as sickle cell anemia, multiple myeloma, or leukemia). However, there are no controlled clinical data on the safety or efficacy of VIAGRA in patients with sickle cell or related anemias.

Effects On The Eye

Physicians should advise patients to stop use of all phosphodiesterase type 5 (PDE5) inhibitors, including VIAGRA, and seek medical attention in the event of a sudden loss of vision in one or both eyes. Such an event may be a sign of non-arteritic anterior ischemic optic neuropathy (NAION), a rare condition and a cause of decreased vision including permanent loss of vision, that has been reported rarely post-marketing in temporal association with the use of all PDE5 inhibitors. Based on published literature, the annual incidence of NAION is 2.5-11.8 cases per 100,000 in males aged ≥ 50. An observational study evaluated whether recent use of PDE5 inhibitors, as a class, was associated with acute onset of NAION. The results suggest an approximate 2 fold increase in the risk of NAION within 5 half-lives of PDE5 inhibitor use. From this information, it is not possible to determine whether these events are related directly to the use of PDE5 inhibitors or to other factors.

Physicians should consider whether their patients with underlying NAION risk factors could be adversely affected by use of PDE5 inhibitors. Individuals who have already experienced NAION are at increased risk of NAION recurrence. Therefore, PDE5 inhibitors, including VIAGRA, should be used with caution in these patients and only when the anticipated benefits outweigh the risks. Individuals with “crowded” optic disc are also considered at greater risk for NAION compared to the general population, however, evidence is insufficient to support screening of prospective users of PDE5 inhibitors, including VIAGRA, for this uncommon condition.

There are no controlled clinical data on the safety or efficacy of VIAGRA in patients with retinitis pigmentosa (a minority of these patients have genetic disorders of retinal phosphodiesterases); if prescribed, this should be done with caution.

Hearing Loss

Physicians should advise patients to stop taking PDE5 inhibitors, including VIAGRA, and seek prompt medical attention in the event of sudden decrease or loss of hearing. These events, which may be accompanied by tinnitus and dizziness, have been reported in temporal association to the intake of PDE5 inhibitors, including VIAGRA. It is not possible to determine whether these events are related directly to the use of PDE5 inhibitors or to other factors.

Hypotension When Co-administered With Alpha-blockers Or Anti-hypertensives

Alpha-blockers

Caution is advised when PDE5 inhibitors are co-administered with alpha-blockers. PDE5 inhibitors, including VIAGRA, and alpha-adrenergic blocking agents are both vasodilators with blood pressure lowering effects. When vasodilators are used in combination, an additive effect on blood pressure may occur. In some patients, concomitant use of these two drug classes can lower blood pressure significantly [see DRUG INTERACTIONS and CLINICAL PHARMACOLOGY] leading to symptomatic hypotension (e.g., dizziness, lightheadedness, fainting).

Consideration should be given to the following:

Patients who demonstrate hemodynamic instability on alpha-blocker therapy alone are at increased risk of symptomatic hypotension with concomitant use of PDE5 inhibitors. Patients should be stable on alpha-blocker therapy prior to initiating a PDE5 inhibitor.
In those patients who are stable on alpha-blocker therapy, PDE5 inhibitors should be initiated at the lowest dose [see DOSAGE AND ADMINISTRATION].
In those patients already taking an optimized dose of a PDE5 inhibitor, alpha-blocker therapy should be initiated at the lowest dose. Stepwise increase in alpha-blocker dose may be associated with further lowering of blood pressure when taking a PDE5 inhibitor.
Safety of combined use of PDE5 inhibitors and alpha-blockers may be affected by other variables, including intravascular volume depletion and other anti-hypertensive drugs.

Anti-hypertensives

VIAGRA has systemic vasodilatory properties and may further lower blood pressure in patients taking antihypertensive medications.

In a separate drug interaction study, when amlodipine, 5 mg or 10 mg, and VIAGRA, 100 mg were orally administered concomitantly to hypertensive patients mean additional blood pressure reduction of 8 mmHg systolic and 7 mmHg diastolic were noted.

Adverse Reactions With The Concomitant Use Of Ritonavir

The concomitant administration of the protease inhibitor ritonavir substantially increases serum concentrations of sildenafil (11-fold increase in AUC). If VIAGRA is prescribed to patients taking ritonavir, caution should be used. Data from subjects exposed to high systemic levels of sildenafil are limited. Decreased blood pressure, syncope, and prolonged erection were reported in some healthy volunteers exposed to high doses of sildenafil (200-800 mg). To decrease the chance of adverse reactions in patients taking ritonavir, a decrease in sildenafil dosage is recommended.

Combination With Other PDE5 Inhibitors Or Other Erectile Dysfunction Therapies

The safety and efficacy of combinations of VIAGRA with other PDE5 Inhibitors, including REVATIO or other pulmonary arterial hypertension (PAH) treatments containing sildenafil, or other treatments for erectile dysfunction have not been studied. Such combinations may further lower blood pressure. Therefore, the use of such combinations is not recommended.

Effects On Bleeding

There have been postmarketing reports of bleeding events in patients who have taken VIAGRA. A causal relationship between VIAGRA and these events has not been established. In humans, VIAGRA has no effect on bleeding time when taken alone or with aspirin. However, in vitro studies with human platelets indicate that sildenafil potentiates the antiaggregatory effect of sodium nitroprusside (a nitric oxide donor). In addition, the combination of heparin and VIAGRA had an additive effect on bleeding time in the anesthetized rabbit, but this interaction has not been studied in humans.

The safety of VIAGRA is unknown in patients with bleeding disorders and patients with active peptic ulceration.

Counseling Patients About Sexually Transmitted Diseases

The use of VIAGRA offers no protection against sexually transmitted diseases. Counseling of patients about the protective measures necessary to guard against sexually transmitted diseases, including the Human Immunodeficiency Virus (HIV), may be considered.

Patient Counseling Information

See FDA-approved patient labeling

Nitrates

Physicians should discuss with patients the contraindication of VIAGRA with regular and/or intermittent use of nitric oxide donors, such as organic nitrates or organic nitrites in any form [see CONTRAINDICATIONS].

Guanylate Cyclase (GC) Stimulators

Physicians should discuss with patients the contraindication of VIAGRA with use of guanylate cyclase stimulators such as riociguat.

Concomitant Use with Drugs Which Lower Blood Pressure

Physicians should advise patients of the potential for VIAGRA to augment the blood pressure lowering effect of alpha-blockers and anti-hypertensive medications. Concomitant administration of VIAGRA and an alpha-blocker may lead to symptomatic hypotension in some patients. Therefore, when VIAGRA is co-administered with alpha-blockers, patients should be stable on alpha-blocker therapy prior to initiating VIAGRA treatment and VIAGRA should be initiated at the lowest dose.

Cardiovascular Considerations

Physicians should discuss with patients the potential cardiac risk of sexual activity in patients with preexisting cardiovascular risk factors. Patients who experience symptoms (e.g., angina pectoris, dizziness, nausea) upon initiation of sexual activity should be advised to refrain from further activity and should discuss the episode with their physician.

Sudden Loss of Vision

Physicians should advise patients to stop use of all PDE5 inhibitors, including VIAGRA, and seek medical attention in the event of a sudden loss of vision in one or both eyes. Such an event may be a sign of non-arteritic anterior ischemic optic neuropathy (NAION), a cause of decreased vision including possible permanent loss of vision, that has been reported rarely post-marketing in temporal association with the use of all PDE5 inhibitors. It is not possible to determine whether these events are related directly to the use of PDE5 inhibitors or to other factors. Physicians should discuss with patients the increased risk of NAION in individuals who have already experienced NAION in one eye. Physicians should also discuss with patients the increased risk of NAION among the general population in patients with a “crowded” optic disc, although evidence is insufficient to support screening of prospective users of PDE5 inhibitor, including VIAGRA, for this uncommon condition.

Sudden Hearing Loss

Physicians should advise patients to stop taking PDE5 inhibitors, including VIAGRA, and seek prompt medical attention in the event of sudden decrease or loss of hearing. These events, which may be accompanied by tinnitus and dizziness, have been reported in temporal association to the intake of PDE5 inhibitors, including VIAGRA. It is not possible to determine whether these events are related directly to the use of PDE5 inhibitors or to other factors.

Priapism

Physicians should warn patients that prolonged erections greater than 4 hours and priapism (painful erections greater than 6 hours in duration) have been reported infrequently since market approval of VIAGRA. In the event of an erection that persists longer than 4 hours, the patient should seek immediate medical assistance. If priapism is not treated immediately, penile tissue damage and permanent loss of potency may result.

Avoid Use with other PDE5 Inhibitors

Physicians should inform patients not to take VIAGRA with other PDE5 inhibitors including REVATIO or other pulmonary arterial hypertension (PAH) treatments containing sildenafil. Sildenafil is also marketed as REVATIO for the treatment of PAH. The safety and efficacy of VIAGRA with other PDE5 inhibitors, including REVATIO, have not been studied.

Sexually Transmitted Disease

The use of VIAGRA offers no protection against sexually transmitted diseases. Counseling of patients about the protective measures necessary to guard against sexually transmitted diseases, including the Human Immunodeficiency Virus (HIV), may be considered.

Nonclinical Toxicology

Carcinogenesis, Mutagenesis, Impairment Of Fertility

Carcinogenesis

Sildenafil was not carcinogenic when administered to rats for 24 months at a dose resulting in total systemic drug exposure (AUCs) for unbound sildenafil and its major metabolite of 29-and 42-times, for male and female rats, respectively, the exposures observed in human males given the Maximum Recommended Human Dose (MRHD) of 100 mg. Sildenafil was not carcinogenic when administered to mice for 18-21 months at dosages up to the Maximum Tolerated Dose (MTD) of 10 mg/kg/day, approximately 0.6 times the MRHD on a mg/m² basis.

Mutagenesis

Sildenafil was negative in in vitro bacterial and Chinese hamster ovary cell assays to detect mutagenicity, and in vitro human lymphocytes and in vivo mouse micronucleus assays to detect clastogenicity.

Impairment of Fertility

There was no impairment of fertility in rats given sildenafil up to 60 mg/kg/day for 36 days to females and 102 days to males, a dose producing an AUC value of more than 25 times the human male AUC.

Use Viagra In Specific Populations

Pregnancy

Pregnancy Category B.

VIAGRA is not indicated for use in women. There are no adequate and well-controlled studies of sildenafil in pregnant women.

Risk Summary

Based on animal data, VIAGRA is not predicted to increase the risk of adverse developmental outcomes in humans.

Animal Data

No evidence of teratogenicity, embryotoxicity or fetotoxicity was observed in rats and rabbits which received up to 200 mg/kg/day during organogenesis. These doses represent, respectively, about 20 and 40 times the Maximum Recommended Human Dose (MRHD) on a mg/m² basis in a 50 kg subject. In the rat pre-and postnatal development study, the no observed adverse effect dose was 30 mg/kg/day given for 36 days. In the nonpregnant rat the AUC at this dose was about 20 times human AUC.

Pediatric Use

VIAGRA is not indicated for use in pediatric patients. Safety and effectiveness have not been established in pediatric patients.

Geriatric Use

Healthy elderly volunteers (65 years or over) had a reduced clearance of sildenafil resulting in approximately 84% and 107% higher plasma AUC values of sildenafil and its active N-desmethyl metabolite, respectively, compared to those seen in healthy young volunteers (18-45 years). Due to age-differences in plasma protein binding, the corresponding increase in the AUC of free (unbound) sildenafil and its active N-desmethyl metabolite were 45% and 57%, respectively.

Of the total number of subjects in clinical studies of Viagra, 18% were 65 years and older, while 2% were 75 years and older. No overall differences in safety or efficacy were observed between older ( > 65 years of age) and younger ( < 65 years of age) subjects.

However, since higher plasma levels may increase the incidence of adverse reactions, a starting dose of 25 mg should be considered in older subjects due to the higher systemic exposure.

Renal Impairment

No dose adjustment is required for mild (CLcr=50-80 mL/min) and moderate (CLcr=30-49 mL/min) renal impairment. In volunteers with severe renal impairment (Clcr < 30 mL/min), sildenafil clearance was reduced, resulting in higher plasma exposure of sildenafil (~2 fold), approximately doubling of Cmax and AUC. A starting dose of 25 mg should be considered in patients with severe renal impairment.

Hepatic Impairment

In volunteers with hepatic impairment (Child-Pugh Class A and B), sildenafil clearance was reduced, resulting in higher plasma exposure of sildenafil (47% for C max and 85% for AUC). The pharmacokinetics of sildenafil in patients with severely impaired hepatic function (Child-Pugh Class C) have not been studied. A starting dose of 25 mg should be considered in patients with any degree of hepatic impairment.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Viagra only for the indication prescribed.  

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.  

Please if you have any questions about Viagra and Erectile Dysfunction, you can ask us by commenting below this text, we'll answer you as soon as possible.

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