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How does Viagra work?

Viagra functions by amplifying blood circulation to the penis upon sexual stimulation, aiding men in obtaining and maintaining an erection for the duration of sexual intercourse.

The active component present in Viagra is sildenafil, which is medically categorized as a PDE5 inhibitor. Sildenafil blocks the enzyme PDE5 that governs blood flow to the penis. PDE5 inhibitors enhance the natural arousal process while facilitating increased blood flow to the penis when sexually stimulated. Although sildenafil assists in achieving an erection, it depends on natural arousal as a prerequisite. Other PDE5 inhibitors like tadalafil, vardenafil, and avanafil similarly aid sexual activity when faced with erectile challenges.

How to take Viagra

The standard initial dose for Viagra is one 50mg tablet for men who are using it for the first time. However, men over 65 years of age are typically advised to start with the lowest available dosage, which is 25mg.

Viagra typically becomes effective within 30 to 60 minutes after ingestion and remains active for around 4 hours.

If a 50mg tablet proves to be highly effective, subsequent doses may be adjusted to one 25mg tablet. Conversely, if the 50mg dose does not yield satisfactory results or if the duration of effectiveness falls short of 4 hours, the dosage can be increased to one 100mg tablet. It is important to refrain from taking Viagra more than once within a 24-hour period or exceeding the 100mg limit. Higher doses do not necessarily correlate with improved outcomes and may elevate the risk of severe side effects.

Sexual arousal is required for the medication to function effectively. The ideal time to take Viagra is just prior to anticipated sexual activity, allowing for sufficient time for effectiveness to occur. In the absence of sexual arousal, the medication will not provide any benefit and its effects are expected to diminish after approximately 4 hours.

Avoidance of large meals, high-fat foods, excessive alcoholic beverages, and grapefruit is recommended, as these variables can potentially impair efficacy.

Viagra dosage

It is essential to not exceed one dose or more than 100mg of Viagra within 24 hours, as well as to refrain from combining it with other erectile dysfunction medications.

Does Viagra work every time?

For optimal evaluation of erectile dysfunction medication efficacy, it is advisable to test it at least 4 times before determining whether Viagra is effective and prior to requesting adjustments in dosage or switching to a different ED medication. Much like any treatment, there may be occasions when ED tablets do not yield results and might not address the underlying issues causing erectile dysfunction.

Successful erections necessitate:

• Sufficient blood supply
• Sexual arousal
• A robust nervous system

If erectile dysfunction arises due to spinal cord injuries or surgical interventions, nerve damage may occur, potentially limiting Viagra's effectiveness. In such cases, alternative methods such as injections or penile devices may be more suitable.

Other causes of erectile dysfunction may require specialized treatments beyond oral medications. Some men experiencing psychological factors behind their erectile dysfunction may benefit from counseling.

Clinical research indicates the following results:

Graph: sildenafil 100mg bioavailability over time, with and without food.

Viagra warnings

As part of the assessment process with Dr Fox, men are asked to fill out a medical questionnaire to determine suitability.

Men with the following conditions should not take Viagra without further evaluation from their GP:

• Use of nitrates (commonly prescribed for chest pain)
• Use or intention to use amyl nitrite ('poppers')
• Use of riociguat (for treating high blood pressure in the lungs)
• Low or high blood pressure
• Allergic reactions to previous ED therapies
• Recent heart attack (within the last 6 weeks) or history of angina or heart disease
• History of strokes or transient ischemic attacks (mini-strokes)
• Vision issues caused by circulation problems
• Family history of rare degenerative eye diseases
• Severe kidney or liver impairment
• Peyronie’s disease – pronounced angulation or deformity of the penis
• Leukemia, multiple myeloma, or sickle cell disease
• Bleeding disorders (like hemophilia)
• Active peptic or gastric ulcers
• Lactose intolerance (tablets contain lactose)

It is important to note that Dr Fox cannot supply ED treatments to men with any of the above conditions.

A very rare but theoretical risk of abnormal heart rhythm may arise if Viagra (sildenafil) is taken concurrently with certain other medications—please refer to the comprehensive list.

Keep all medications out of children's reach and sight.

Possible side effects of Viagra

Viagra is generally well tolerated with a low incidence of significant side effects among most men. The medication enhances blood circulation, which can result in mild adverse effects on other bodily systems. Most men who do report side effects continue their treatment without interruption.

Just over 1% of men using Viagra may notice a slight blue or yellow tint in their vision. This is typically not alarming and does not interfere with daily