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What is Viagra (Sildenafil)?

Viagra (sildenafil) is a prescription medication used for the treatment of erectile dysfunction. It may be used by itself as an effective treatment or may be prescribed alongside additional medications for this condition.

How is Viagra Used?

Viagra is typically taken 30 to 60 minutes prior to sexual activity in order to allow a patient to successfully have an erection. However, Viagra is not a substitute for the mental and physical stimulation required to achieve an erection in the first place. It may be used once per day.

Storage

Viagra should be stored at room temperature and away from moisture and direct light. It should not be stored in the bathroom.

Keep this medication out of the reach of pets and children at all times.

When this medication is no longer needed or has expired, patients should contact their local waste disposal company or pharmacy to ensure proper disposal. Viagra should never be poured down a drain or flushed via a toilet for disposal.

Uses

Viagra is prescribed for the treatment of erectile dysfunction.

Under other brand names, sildenafil may also be used for the treatment of the following:

  • heart disease
  • pulmonary heart disease
  • pulmonary hypertension
  • pulmonary impairment
  • thromboembolic pulmonary hypertension
  • vascular disease

How Does Viagra Work?

This medication belongs to a class of drugs known as PAH, PDE-5 Inhibitors, or Phosphodiesterase-5 Enzyme Inhibitors. PAH PDE-5 (phosphodiesterase-5) inhibitors function by relaxing the smooth muscles of a patient’s pulmonary arteries. This allows them to dilate, making these medications ideal for reducing a person’s blood pressure levels.

Viagra falls into this category yet works by improving blood flow to a patient’s penis instead. Sildenafil under the name of Revatio is used for improving pulmonary arterial hypertension by comparison.

Viagra assists patients in maintaining an erection, but it does not cure erectile dysfunction nor provide the desire required to stimulate an erection by itself.

Dosage

Viagra is available in three different dosages options:

  • 25 mg
  • 50 mg
  • 100 mg

The most commonly prescribed dosage is 50 mg, and the medication may be taken as needed within 30 to 60 minutes before engaging in sexual activity.

Viagra may also be taken any time between 30 minutes to 4 hours before engaging in sexual activity. Eating a high-fat meal before taking Viagra may cause the medication to take longer to begin working. However, it may be taken either with or without food with no significant differences between the two.

It is not recommended to exceed the maximum dose of 100 mg of Viagra one time a day. However, a patient’s preexisting medical conditions, as well as their weight, may determine the effectiveness as well as the speed at which the medication begins working.

Patients should take this medication exactly as prescribed by their doctor and not exceed their prescribed dosage. If patients take a higher dose or multiple doses of a lower dose, they are advised to contact their doctor for further medical advice due to the potential cardiovascular health risks.

Overdose

If a patient taking overdosed on Viagra and experiences significant symptoms such as difficulty breathing or passing out, they should call 911 immediately. If the symptoms are less severe but still present, it is recommended that they contact their local Poison Control Center or doctor for further advice.

Symptoms of overdosing on Viagra may include fainting, dizziness, or a prolonged or painful erection.

Side Effects

Viagra is capable of producing undesired side effects in some individuals, particularly those with certain preexisting health conditions.

The most common side effects of taking Viagra are as follows:

  • abnormal vision
  • back pain
  • diarrhea
  • difficulty sleeping
  • difficulty differentiating between the colors green and blue
  • dizziness
  • flushing of the skin
  • headache
  • heartburn
  • light sensitivity
  • muscle pain
  • nose bleeds
  • numbness in the feet, legs, hands, or arms
  • runny nose
  • seeing a blue tinge present when looking around
  • stuffy nose
  • tingling in the hands, feet, arms, or legs
  • upset stomach

Some of the following side effects may occur while taking Viagra. If you experience any of these serious side effects, contact your doctor immediately:

  • convulsions
  • cough with foamy mucus
  • breathing difficulties (extreme shortness)
  • feeling as if you’re about to pass out
  • irregular heartbeat
  • ringing in the ears
  • seizure
  • swelling in the feet, ankles, or hands
  • sudden hearing loss

Please seek emergency medical assistance if you experience any of the following additional side effects:

  • painful or prolonged erection (more than 4 hours — this can cause permanent damage)
  • sudden vision loss or significant vision changes
  • symptoms of a heart attack
    • nausea
    • sweating
    • pain spreading to your shoulder or jaw
    • chest pain
    • chest pressure

These may result in permanent physical damage or worse.

The information above does not list all possible side effects. Contact your doctor or pharmacist if you experience any side effects that are not listed. You or your doctor may report side effects to the FDA by calling 1-800-FDA-1088.

Warnings & Precautions

If you are taking Revatio, do not take Viagra without explicit instruction from your physician.

Additionally, there are some other associated health concerns for patients taking Viagra. Please discuss any questions or concerns you may have with your doctor before beginning treatment with Viagra.

Food Interactions

Viagra should not be taken with any foods or products containing grapefruit, as this may result in undesired side effects occurring. Additionally, side effects may be caused or amplified when using this medication while consuming alcohol. Both of these should be avoided while taking Viagra.

Sudden Vision Loss

Some patients taking Viagra have experienced a sudden loss of vision due to the decreased flow of blood to the optic nerve. This side effect is most common in those who have a history of high blood pressure, diabetes, high cholesterol, heart disease, or certain eye conditions that were present before beginning the medication. Individuals who were above the age of 50 years old or who were smokers have also been shown to be more likely to experience sudden vision loss when taking this medication.

Hearing Loss

PDE-5 inhibitors have been linked to patients experiencing tinnitus and dizziness, as well as a sudden decrease in hearing capabilities and even a sudden loss of hearing abilities. Individuals who experience this sudden hearing loss should contact their doctor immediately or seek out other medical care, such as calling 911 or visiting their closest emergency room.

Underage Use

Viagra should never be given to any individuals below the age of 18 years without specific medical advice to do so. It has not been determined to be safe or effective for anyone falling into this age range. Viagra should be kept out of the reach of children and teens at all times.

Use Alongside Similar Medications

There have been no studies on the efficacy and safety of using Viagra alongside similar PAH medications or PDE-5 inhibitors. There is believed to be a risk of blood pressure dropping even lower when hypothetically using these types of medications in conjunction with each other. It is currently recommended not to combine Viagra with medications that are similar in function.

Nitrates

Patients should not take Viagra if they are also using any nitrate medications for the treatment of heart troubles or chest pain. Mixing these two medications can cause a sudden and significant decrease in a patient’s blood pressure and result in symptoms of dizziness, fainting, dehydration, blurred vision, and fainting. If you have mixed these medications and are experiencing symptoms of severe low blood pressure, contact your doctor. Some of the nitrate medications that may interact with Viagra include isosorbide mononitrate, isosorbide dinitrate, nitroglycerin, and the recreational drugs amyl nitrate or amyl nitrite (otherwise known as “poppers”).

Preexisting Cardiovascular Conditions

For individuals who have been advised to avoid or limit sexual activity due to the risk of complications associated with preexisting heart conditions and cardiovascular disease, there is an increased risk of cardiac complications during such activities with or without Viagra. If a patient is at an increased risk of a cardiac event taking place during sexual intercourse, the risks should be discussed with a doctor before beginning treatment with Viagra.

Priapism and Prolonged Erections

Priapism refers to painful erections that persist for over 6 hours, with prolonged erections simply referring to those that last between 4 to 6 hours in duration. Individuals with certain health conditions are more likely to experience such side effects, such as patients who have leukemia, multiple myeloma, or sickle cell anemia. Additionally, individuals with penile deformities are also at an increased risk for prolonged erections. Some of the deformities that are known to coincide with priapism attributed to Viagra include Peyronie’s disease, cavernosal fibrosis, and angulation. For erections that last longer than four hours, patients are recommended to seek immediate medical attention to avoid a permanent loss of potency as well as possible tissue damage in the penis.

Additional Medical Conditions

If you have any of the following medical conditions, exercise caution when taking Viagra and discuss your medical history with your doctor before beginning this medication:

  • arrhythmia
  • aortic stenosis
  • bleeding conditions
  • blood cell disorders
  • blood circulation issues
  • blindness (in both eyes or just one)
  • coronary artery disease
  • heart attack
  • hypertension (resting)
  • hypotension (resting)
  • idiopathic hypertrophic subaortic stenosis
  • kidney disease
  • leukemia
  • liver disease
  • multiple myeloma
  • penile deformity
  • Peyronie’s disease
  • pulmonary veno-occlusive disease (PVOD)
  • retinis pigmentosa
  • sickle cell anemia
  • stomach ulcer
  • stroke

You should also discuss with your doctor if you have been instructed at any point and for any reason not to have sexual intercourse due to health reasons.

Drug Interactions

Speak to your doctor about any medications or herbal supplements you are currently taking before beginning treatment with Viagra. Discuss any concerns you may have with your doctor or a trusted pharmacist.

Drugs and Substances That Increase the Risk of Viagra Side Effects

The following medications and substances are known to interact with Viagra and may increase your chances of experiencing adverse side effects associated with taking Viagra:

  • abiraterone
  • alcohol
  • alpha agonists
  • alpha-blockers
  • alprostadil
  • amiodarone
  • amlodipine
  • amyl nitrite (“poppers”)
  • angiotensin converting enzyme inhibitors (ACEIs)
  • angiotensin receptor blockers (ARBs)
  • aprepitant
  • aripiprazole
  • atazanavir
  • atenolol
  • atorvastatin
  • “azole” antifungal medications
  • barbiturates
  • beta-adrenergic blockers
  • bicalitamide
  • boceprevir
  • bosentan
  • butalbital
  • calcium channel blockers
  • candesartan
  • captopril
  • carbamazepine
  • clarithyromycin
  • clonidine
  • cobistat
  • conivaptan
  • dasatinib
  • deferasirox
  • delaviridine
  • dexamethasone
  • diltiazem
  • diuretics (water pills)
  • dofetilide
  • doxazosin
  • dronedarone
  • efavirenz
  • enalapril
  • enzalutamide
  • erythromycin
  • etravirine
  • furosemide
  • fusidic acid
  • guanfacine
  • HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs)
  • HIV protease inhibitors
  • hydralazine
  • hydrochlorothiazide
  • imatinib
  • indinavir
  • irbesartan
  • isosorbide dinitrate
  • isosorbide mononitrate
  • itraconazole
  • ketoconazole
  • losartan
  • lovastatin
  • macrolide antibiotics
  • methyldopa
  • metronidazole
  • mifepristone
  • mitotane
  • nefazodone
  • nevirapine
  • nifedipine
  • nilotinib
  • nitrates
  • nitroglycerin
  • norfloxacin
  • oxcarbazepine
  • peginterferon Alfa-2b
  • pentobarbital
  • phenobarbital
  • phenytoin
  • other phosphodiesterase 5 inhibitors
  • pimozide
  • primidone
  • propranolol
  • ramipril
  • rifabuton
  • rifampin
  • riociquat
  • ritonavir
  • John’s wort
  • Sapropterin
  • saquinavir
  • sertraline
  • siltuximab
  • simeprevir
  • simvastatin
  • sotalol
  • “statin” medications
  • stiripentol
  • sunitinib
  • tadalafil
  • telaprevir
  • terazosin
  • tocilizumab
  • triamterene
  • tyrosine kinase inhibitors
  • vardenafil
  • verapamil
  • voriconazole

Substances That May Make Viagra Less Effective

When taken with the following, Viagra may be less effective and not work as well:

  • high-fat meals
  • grapefruit or any products containing grapefruit

Alternative Medications

For patients who are unable to take Viagra, experiencing significant adverse side effects, or are unable to afford the medication, alternative medications may be used to treat some of the associated conditions for which this medication is commonly prescribed:

  • Cialis (tadalafil)
  • Levitra (vardenafil)
  • Staxyn (vardenafil)
  • Stendra (avanafil)

Each of these medications has its own specific time range for efficacy as well as limitations on how often it may be taken. Please consult with your doctor if you have any questions about these alternative medications as compared to the common experience one may have when taking Viagra.

Frequently Asked Questions

You should take Viagra exactly as your doctor prescribed you to take it. It typically should be taken roughly one hour prior to engaging in sexual activity. However, you can take Viagra between 30 minutes to four hours prior to sexual activity. Do not take more than one dose of Viagra each day.

Viagra can be taken with or without regard to food. If you take Viagra after eating a meal high in fat (e.g., a cheeseburger), it may take longer for Viagra’s effects to kick in.

If you overdose on Viagra, immediately contact your doctor or go to the closest emergency room.

Common side effects of Viagra include:
  • Stuffy nose
  • Headache
  • Redness or warmth in the chest, neck, or face
  • Stomach pain
  • Upset stomach
  • Diarrhea
  • Nausea
  • Back pain
  • Memory issues
  • Dizziness
  • Hearing loss
  • Ringing in the ears
  • Trouble differentiating between green and blue colors

Viagra should be stored at room temperature between 68°F to 77°F (20°C to 25°C).

Tell your doctor about all the medications you take, including prescription medications, over-the-counter medications, herbal supplements, and vitamins. Viagra can change how other drugs work, and other drugs can change how Viagra works. Tell your doctor especially if you take any of the following medications:
  • Medicines for high blood pressure
  • Other medicines to treat ED
  • Medicines known as nitrates
  • Medicines known as alpha blockers
  • Medicines to treat HIV
  • Antibiotics or antifungals
  • Medicines known as guanylate cyclase stimulators (e.g., riociguat/Adempas)
Additionally, let your doctor know if you:
  • Have or have had heart problems
  • Have had a stroke
  • Have pulmonary hypertension
  • Have low blood pressure
  • Have uncontrolled blood pressure
  • Have had heart surgery in the past six months
  • Have had an erection for longer than four hours
  • Have a deformed penis shape
  • Have bleeding problems
  • Have conditions affecting your blood cells (e.g., leukemia, multiple myeloma, or sick cell anemia)
  • Have ever had serious loss of vision or an eye problem known as NAION
  • Have an eye condition known as retinitis pigmentosa
  • Have had stomach ulcers
  • Have had problems with your kidneys
  • Have had problems with your liver

When a patient’s primary cause of erectile dysfunction is physical, Viagra is very effective at helping them achieve an erection when desired. If a patient’s erectile dysfunction is attributed to psychological factors, Viagra may be less effective.

Due to the risk of side effects, individuals taking Viagra should not consume alcohol or any products containing grapefruit.

Viagra is able to help an individual maintain an erection even after experiencing ejaculation, often decreasing the time required to regain an erection again.

Patients with diabetes or certain heart conditions that take Viagra may find it to be less effective in some cases.

For individuals who experience side effects of Viagra (such as indigestion, nasal congestion, or flushing of the skin, these symptoms typically subside within several hours. If you are experiencing significant or persistent side effects after taking Viagra, please contact your doctor.

For patients who struggle with early ejaculation and incorporate the use of creams that reduce sensitivity during sexual activity, the use of Viagra alongside these creams is perfectly safe.

If a patient is unable to get an erection each time they want to have sex, have difficulty getting an erection in general, or have trouble maintaining an erection during sexual activity, these individuals are most likely to benefit from taking Viagra.

Viagra typically leaves a patient’s system within 2 to 3 hours. However, some individuals may have a slower metabolism that will cause it to still be present in their system for up to 6 hours. This duration is determined by both the dosage and a patient’s metabolism. It may be detected in a urine test for about 24 hours.

Viagra is an oral medication, and these medications must be broken down and absorbed through an individual’s gastrointestinal tract. There is no way to speed up this process in most cases, but individuals may find the medication to work quicker if taken on an empty stomach.

Viagra should only be taken once per day, and patients should not exceed this dose. If you are struggling with erectile dysfunction but would like to have treatment that allows for multiple instances of sexual activity outside of Viagra’s average timeframe of efficacy, please speak to your doctor about possible options.

The ingredients in many of these products are not always accurately listed and may not always work as intended. Due to the risk of quite a few of the pills containing powdered sildenafil without explicitly listing it as an ingredient, it is strongly advised that patients taking Viagra do not mix them together.

Viagra is not studied nor approved for use in women. Women who struggle with sexual dysfunction should discuss this condition with their doctor as many Viagra-equivalent medications are now available specifically for use in females.

Viagra should not be mixed with other erectile dysfunction medications due to the increased risk of side effects and adverse results of combining multiple similar medications. If Viagra is not working effectively for you, contact your doctor about adjusting your dose.

It is advised to not take Viagra when smoking or otherwise consuming marijuana-based products. Marijuana has been shown to affect the proper metabolism of the medication and result in an increased risk of cardiovascular adverse effects.

Counterfeit Viagra has been shown to include a number of hazardous ingredients and is not always guaranteed to contain the correct or even any sildenafil. The counterfeit variations of this medication have been found to contain drywall and other binding agents, blue printer ink, no or too much sildenafil, metronidazole, and amphetamines. All individuals are strongly advised to avoid taking counterfeit medication due to the serious health risks such action poses.

Viagra is capable of expiring, and the expiration date will be listed on the container. Do not use Viagra after it has expired, and be sure to dispose of the medication properly. Do not flush or toss in the trash. Contact a pharmacist or local waste services for more information on proper disposal.

There are currently no such products that function in the same manner as Viagra for the treatment of erectile dysfunction, and many that have falsely claimed such efficacy have been recalled. Individuals are advised against taking any herbal supplement that makes such claims.

Disclaimer

Pharma Giant provides medical information to help you better understand medications and medical conditions.This content is for informational use only and does not replace advice from a licensed medical practitioner. Consult your doctor or pharmacist before starting or changing any medication. All our partners follow strict safety standards set by their country’s health authorities to make sure you receive safe and high-quality medications.

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Jakob Leaderbrand, PharmD, CSP

Jakob Leaderbrand, PharmD, is a licensed pharmacist with extensive experience in specialty pharmacy and clinical program management. Based in the Kansas City metro area, he holds a Doctor of Pharmacy degree from the University of Missouri-Kansas City and a Specialty Pharmacy Certification. Currently, Jakob works in Specialty Pharmacy, where he leverages his clinical expertise to drive adherence, improve patient outcomes, and ensure compliance through effective communication of complex data insights. Jakob is known for his commitment to operational excellence and for leading initiatives that streamline patient assessments and enhance audit compliance, making a significant impact on patient care and client relationships in the pharmacy sector.