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How does Viagra work?

Viagra enhances blood flow to the penis when sexual stimulation occurs, aiding men in achieving and maintaining an erection sufficient for engaging in sexual activities.

The active ingredient in Viagra is sildenafil, which is clinically recognized as a PDE5 inhibitor. Sildenafil functions by obstructing the activity of the PDE5 enzyme that moderates blood flow to the penis. By doing so, PDE5 inhibitors amplify the natural arousal process, leading to increased blood flow during sexual stimulation. It's essential to note that while sildenafil can assist in achieving an erection, natural arousal is necessary for it to be effective. Other medications, including tadalafil, vardenafil, and avanafil, fall into the same category of PDE5 inhibitors that support sexual relations when typical erectile functions may be lacking.

How to take Viagra

The typical starting dose of Viagra is one 50mg tablet for men who haven't taken it before, although men aged over 65 may start on the lower dose of 25mg.

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

If the 50mg strength proves to be significantly effective, subsequent doses may be decreased to one 25mg tablet. Conversely, if the 50mg tablet fails to deliver satisfactory results or if the duration of its effects falls short of 4 hours, the dosage can be increased to one 100mg tablet. It’s important not to exceed one dose or 100mg of Viagra within a 24-hour period, nor to combine it with other erectile dysfunction medications. Higher doses have not been shown to enhance efficacy and can indeed increase the risk of experiencing serious side effects.

It is essential to engage in sexual arousal for the medication to work effectively. Viagra is best taken in anticipation of sexual activity within one to two hours after ingestion. Without such stimulation, the medication will lose its effectiveness after approximately 4 hours.

It is advisable to avoid large meals, fatty foods, excessive alcohol consumption, and grapefruit, as these may adversely affect the efficacy of the medication.

Viagra dosage

Do not exceed a single dose or 100mg of Viagra within a 24-hour timeframe, nor combine it with other erectile dysfunction medications.

Does Viagra work every time?

To accurately determine the effectiveness of erectile dysfunction medication, a trial involving the usage of Viagra should be conducted at least four times before assessing whether it is effective or if a dosage change is warranted. As with any treatment regimen, there will be occasions when ED medications may not perform as intended or fail to address the underlying causes of erectile dysfunction.

For satisfactory erections to occur, the following factors must be met:

• Proper blood supply
• Sexual arousal
• A healthy nervous system

If erectile dysfunction is due to a spinal injury or surgical intervention, there may be nerve damage, making Viagra only somewhat beneficial, with additional measures, like injections or mechanical aids, possibly necessary.

Other underlying causes of erectile dysfunction might require treatments that extend beyond oral medications. In cases where psychological factors contribute to erectile dysfunction, counselling may provide significant benefit.

Clinical studies report the following efficacy results:

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

Viagra warnings

As part of the evaluation process with Dr Fox, men are required to complete a medical questionnaire to ascertain suitability.

Men with the following conditions should refrain from using Viagra without further assessment from their GP:

• Use of medications termed nitrates (commonly prescribed for chest pain)
• Current use or intention to use amyl nitrite ('poppers')
• Taking riociguat (for elevated pulmonary blood pressure)
• Instances of low or high blood pressure
• Allergic reactions or previous adverse reactions to erectile dysfunction treatments
• Recent heart attacks (within the last six weeks) or suffering from angina (heart pain during exertion) or any form of coronary heart disease
• History of strokes or transient ischemic attacks (mini-strokes)
• Previous issues with vision linked to circulation
• Family history of rare degenerative eye disease
• Severe kidney or liver disease
• Peyronie's disease – characterized by penile angulation or deformity
• Blood disorders like leukaemia, multiple myeloma, or sickle cell disease
• Active ulcers (either peptic or gastric)
• Lactose intolerant (the tablets contain lactose)

Dr Fox is unable to supply ED treatment to men diagnosed with any of the above-mentioned conditions.

There exists an exceedingly rare theoretical risk of abnormal heart rhythm when Viagra (sildenafil) is taken concurrently with certain other medications; kindly confirm this list for clarity.

Keep all medications securely stored out of reach of children.

Possible side effects of Viagra

Viagra is generally well tolerated among the vast majority of men who use it and is rarely associated with serious side effects. As Viagra enhances blood flow, it may have minor adverse effects on other areas of the body; however, these effects are usually mild. Most men who do experience side effects continue the treatment regimen without discontinuation.

Approximately 1% of men taking Viagra might experience a bluish or yellowish tinge to their vision. This occurrence is typically not alarming and does not hinder normal activities; it generally resolves after a few hours.

In clinical studies, the most frequently reported adverse reactions included:

• Headache - very common and may be alleviated using simple painkillers such as paracetamol.