Viagra: The OG ED Medication

Quick Facts and Figures about Sildenafil Citrate

Credit: Nick Duell / Unsplash

Disclaimer: Your healthcare provider is the best source of health and medical information. Articles written by UPGUYS are informed by peer-reviewed studies and research, as well as governmental health authorities and agencies—but they cannot replace advice from a healthcare professional. Talk to your healthcare provider about any physical or mental health concerns you might have. 

There’s a chance you’ve never heard of Cialis or Levitra, the second and third most popular prescription erectile dysfunction medications. There’s an even better chance you don’t necessarily know what causes erectile dysfunction, or how erectile dysfunction meds work. But no matter what, men the world-over of all ages know about Viagra — the original gangster of ED meds. 

The blue, diamond-shaped tablet that came into our lives in the late 90s was an instant success, and forever changed the conversation about ED. Before Viagra (generic name sildenafil), men had few effective and non-invasive treatment options for overcoming ED. Now, instead of surgeries, pumps, and unreliable herbal remedies, men could take a prescription pill that allowed for more blood flow to the penis and helped to increase erectile function. Hallelujah!

No matter how well-known Viagra may be, we wanted to give you a summary of what you need to know about sildenafil, like we did for tadalafil and vardenafil. Happy reading. 

Quick Facts

Viagra (generic name sildenafil or sildenafil citrate) is the most-popular erectile dysfunction medication in North America and around the World. At its peak in 2012, Viagra brought in revenue of $2.05 billion worldwide. As of 2016, an astonishing 5.4 billion tablets of Viagra had been dispensed to over 64 million men. Viagra/sildenafil hold around 65% of the US market for ED medications

The Basics

Viagra is part of a class of drugs known as PDE-5 inhibitors. PDE-5 inhibitors like Viagra, Cialis and Levitra work to promote blood flow to the penis by relaxing smooth muscles and blood vessels. In combination with sexual stimulation, Viagra helps men better achieve and maintain erections. 

Available Doses

Sildenafil comes in a range of doses, depending on what you and your doctor decide are your particular needs. Most men start at the 50mg dose, with a 100mg variety available if needed. Viagra is meant to be taken 1-2 hours before engaging in sexual activity. It takes about 60 minutes for the drug to take effect, and lasts 4-5 hours. Avoid eating a high-fat meal before taking sildenafil, as it may delay and diminish the medication’s effects. 

How Effective is It?

Clinical trials have shown sildenafil to be around 70% effective versus placebo. Depending on your age, health, and severity of ED, Viagra may be more or less effective. Your doctor will be your best resource in understanding how prescription erectile dysfunction medications might work for you. 

How to Get the Most out of Viagra

Avoid drinking too much alcohol with sildenafil, as it can lower blood pressure and decrease your ability to get and maintain an erection. Additionally, eating or drinking grapefruit products is not recommended when taking Viagra. Maintaining a healthy diet full of whole foods, low in fats and sugar, as well as regular exercise can also help to improve erectile function. Smoking can hamper your ability to get and keep an erection. 

Potential Side Effects

Like with any prescription medication, sildenafil can cause mild or serious side effects in patients. Though it is generally well-tolerated, the following common and rare side effects have been reported in clinical trials. If you experience any of the serious side effects listed below, or if you’re experiencing new or worsening side effects, you should seek medical attention. 

Common Side Effects

  • Headache
  • Indigestion
  • Back Pain
  • Nasal Congestion
  • Runny Nose
  • Facial Flushing

Less Common Side Effects

  • Drop in Blood Pressure
  • Muscle / Limb Pain
  • Pink Eye
  • Blurred Vision

Serious Side Effects

  • Sudden Vision/Hearing Loss
  • Painful Erections Lasting More than Four Hours
  • Tinnitus (Ringing in the Ears)
  • Severe Dizziness
  • Fainting
  • Rash
  • Itching/Swelling of the Face
  • Trouble Breathing

Potentially dangerous drug interactions

It is vitally important you make your doctor aware of any medications—including dietary supplements, over the counter meds, and vitamins—you’re currently taking. Below is a list of medicines that can produce negative interactions when combined with tadalafil—consult your physician for a complete list. 

  • Riociguat and any drugs that contain nitrates (tadalafil can cause a serious drop in blood pressure when used with nitrates, which can lead to dizziness, fainting, and rarely, heart attack or stroke. 
  • Alpha-blockers used to treat prostate problems or high-blood pressure (your blood pressure can get too low which can lead to dizziness or fainting)
  • Vardenafil, Sildenafil or other drugs to treat erectile dysfunction 
  • Other drugs that contain tadalafil (to treat BPH) 
  • Drugs used to treat fungal infections (such as ketoconazole or itraconazole) 
  • Drugs used to treat bacterial infections (such as erythromycin)
  • Drugs used in the treatment of HIV (such as ritonavir and saquinavir)

Talk to Your Doctor

If you’re experiencing erectile dysfunction more than half the time over a prolonged period of time, talk to your doctor. They will be able to assess your symptoms and lay out your treatment options. Sometimes, simple changes to diet and exercise can help improve erectile function. Other times, your doctor may decide that prescription medicine is right for you. 

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