Can Viagra Cause Hours-long Erections ?

The facts: While this may sound intriguing theoretically, this condition (known as priapism) can be harmful.

Fortunately, it doesn’t really happen if you’re only taking Viagra.

 

 

“To my knowledge, Viagra has never caused a prolonged erection by itself,” Dr. Montague says. “But, it can happen if you’re also getting penile injection therapy.”

Combining the treatments has a cumulative effect — penile injection therapy makes your erections hard, and adding Viagra makes them harder and even more long-lasting. So, stay on the safe side and don’t pair them, he says.

How do you use Viagra?

Always take Viagra exactly as prescribed to you by your doctor. Viagra is an oral medication taken in pill form as and when the patient wishes to use it. This is typically between 30 minutes to 1 hour before engaging in sexual activity, although it’s possible to take the drug up to four hours in advance.

It’s usual to start taking Viagra with one 50mg tablet. A doctor may prescribe a lower dose for men over 65.

If you find your prescribed dosage isn´t working for you speak to your doctor. Don´t just increase the amount you take on your own as this could cause side effects.

Also, if the tablet you have taken doesn´t seem to be working at all do not take another. This could be dangerous and cause a painful erection that lasts several hours and damages the penis tissue. Speak to your doctor before commencing with further doses.

Your diet and your overall health will affect how Viagra works for you, including how long its effects last. The average length of time it lasts is between 2 and 3 hours. You may achieve more than one erection after taking one Viagra tablet but you will not have a continuous erection. After ejaculation you may or may not get another erection, depending on your metabolism. And you will only achieve more erections with further sexual stimulation.

You can take Viagra with or without food. If you take it after food or a heavy meal it may take longer to work.

There are many common misconceptions about Viagra, or Viagra more generally. In order for the drug to be effective, you will have to engage in normal sexual stimulation, it will not work on its own or sporadically. If you feel relaxed and comfortable the medication is likely to be more effective and act sooner.

If you do not experience erectile dysfunction then it is not advisable to take Viagra. It will not have any effect, it does not increase libido, penis size, or act as an aphrodisiac. This is a common myth. Viagra also won’t cause an erection without stimulation or for prolonged periods of time. It should be used as an aid for treating erectile dysfunction only.

Why do I need to answer questions to get Viagra Connect?

When trying any new medication it is important that this has been deemed suitable for you to protect your health and well-being. As Viagra Connect is available without a prescription you will no longer need to see a GP, however you will need to complete a discreet and easy questionnaire when you purchase Viagra Connect.

Or if you’d prefer you can chat in-store to a pharmacist, they will be able to answer any additional questions you may have whilst checking your suitability for this treatment. Your pharmacist may ask to review your Summary Care Record or Patient Medication Record to check whether you have any conditions or are on any medication that could react with Viagra Connect.

How can I complete a consultation?

1. Online

If you choose to purchase Viagra Connect online, you’ll be prompted to complete a quick online consultation. The majority of the questions you will be asked simply require a yes or no answer, although you will need to fill in a small part about any medication that you are currently taking.

Once you have completed your answers they’ll be sent to our team to review. They’ll check that you are suitable for Viagra Connect.

You then have the option to get Viagra Connect discreetly delivered to your home for free or next day, or alternatively to click and collect to pick it up in your local LloydsPharmacy or Sainsbury’s store at a time that is convenient for you.

There is a very small chance that you won’t be suitable for Viagra Connect. In this instance Online Doctor offers a wide range of erectile dysfunction treatments, with a variety of strengths and ingredients, so with the help of a GP you’ll find one that is just right for you.

2. In-store

You can speak to an expert pharmacist in complete confidence within your local LloydsPharmacy store at a time that suits you. You don’t need to book an appointment to speak to a pharmacist about purchasing Viagra Connect and whether this medication is right for you.

You’ll have the option to either chat to the pharmacist on the shop floor or go into a discreet consultation room. Your pharmacist will run through a set of pharmacy questions to determine whether Viagra Connect is the right treatment for you. They can also answer any additional questions or concerns you may have whilst offering any extra advice to put your mind at ease.

What questions will I be asked?

If you order Viagra Connect via Online Doctor you will be asked to complete a confidential questionnaire consultation containing straightforward questions. The majority of these require a simple yes or no answer, or multiple choice.

These questions will focus on your overall fitness for sex, to find out if you get out of breath quickly or experience any chest pain when undertaking physical activity.

You’ll also be asked about the health of your heart, any underlying medical conditions, whether you are allergic to any of the ingredients in Viagra Connect and what other medication you are currently taking. It’s important that our doctors understand any medical issues that you may have or any medication that you may be taking.

After you have completed the consultation your answers will be reviewed by a member of our clinical team to determine if you are suitable for Viagra Connect. If you have decided to talk to a Pharmacist in store rather than order online you will be asked a similar set of confidential questions, and the Pharmacist will also be able to answer any questions that you may have.

Viagra Connect and Sildenafil – what’s the difference?

We’ve created a helpful table to compare generic Sildenafil with branded Viagra. If you’re looking to compare our variety of ED treatments and their active ingredients, explore your options at LloydsPharmacy Online Doctor.

Sildenafil (generic) Viagra (branded)
Active ingredient  Sildenal citrate Sildenafil citrate
Available dosage (mg) 25, 50, 100 25, 50, 100
Pack size 4, 8, 16 4, 8, 16
When to take Effective within one hour, up to four hours Effective within one hour, up to four hours
How to take On an empty stomach On an empty stomach
Prices on Online Doctor from £3.25/pill £5.31/pill

 

What are the possible side effects of Viagra Connect?

As with any medication there are always possible side effects, the most commonly reported ones include:

  • Headache
  • Facial flushing
  • Nausea
  • Nasal congestion
  • Dizziness
  • Blurred or blue-tinted vision
  • Indigestion and heartburn

Can I use Viagra Connect if I have a medical condition?

Whether you can use Viagra Connect to treat your erectile dysfunction depends upon the nature of your medical condition and the medication you’re taking. Your Pharmacist will decide if Viagra Connect is suitable for you during your confidential consultation, or a doctor will review your suitability using the answers you provided in your online questionnaire.

How do I take Viagra Connect?

The recommended dose of Viagra Connect is one 50mg tablet to be taken an hour before sexual activity. Viagra Connect usually works within 60 minutes and the effects can be seen up to four hours after the initial dose. You cannot take more than one 50mg tablet a day.

Prices correct April 2020

References

Image for illustrative purposes only. Posed by models.

Can Viagra Cause any Negative Long-lasting Effects?

Viagra is for adult men seeking to treat impotence, or erectile dysfunction. ED is the lack of blood flow to the penis, making it impossible to achieve or maintain an erection for long enough to have satisfactory intercourse. ED can happen due to age, a medical condition or it can be psychological.

Erectile dysfunction is often an embarrassing issue for those who suffer from it and can have many negative effects. Erectile problems can lead to stress in relationships, low self-esteem, and a decreased sex drive. Viagra (Sildenafil) can be an effective treatment for erectile dysfunction if taken correctly, as instructed by a doctor.

Often, men suffering from ED have already tried non-medical remedies to treat it, such as changing their diet, increasing exercise and reducing stress before deciding to seek medical treatment such as Viagra. If you have decided that Viagra is the right option for you we advise you to request a prescription through a doctor to ensure you take the right dosage.

Viagra works alongside sexual stimulation to achieve an erection. When a man becomes aroused something called cyclic GMP is released. This causes the blood vessels to relax and expand and more blood to enter the penis. The result of this is an erection. Cyclic GMP is broken down by an enzyme known as PDE5. Viagra (Sildenafil) works to stop this break down occurring and therefore helps maintain the erection.

Maintaining a healthy sex life is important for psychological and physical well-being. Viagra is an aid for men who have insufficient blood flow to the penis and therefore problems having sex.

When using ED pills, you should be aware of potential risks. Keep in mind that the uncontrolled use of sildenafil medication (for example, when using the drug in excessive doses, or more frequently than recommended, or when the drug is combined with other ED medications from Canadian Pharmacy or narcotic substances) can lead to a condition known as priapism.

It’s a long-lasting painful erection that needs medical help. Priapism is a disease named after the mythical ancient Greek god of fertility Priapus, who had a permanent erection. If a man has priapism, his erection has nothing to do with sexual arousal and the penis does not relax even after ejaculation and after a while it becomes painful. This condition can seriously damage the penis as it can cause blood stasis.

If your erection lasts for more than 4 hours and you feel pain, you should contact your doctor immediately.

In rare cases, Viagra can cause negative effects but they are unlikely to be long-lasting. The common side effects associated with the use of this medication include headache, redness of the face, hot flashes, dizziness, vision problems, sensitivity to light, nasal congestion, and stomach upset.

To avoid side effects of any kind, you should consult a doctor prior to taking these pills. You should be informed that sildenafil medication should not be used in combination with nitrates (medicines used to treat angina pectoris), as this can lead to a severe drop in blood pressure levels, which can lead to shock and sometimes even death.

In 2020, Viagra is considered safe when prescribed correctly.

Important: Prolonged use of ED pills can worsen the fertilizing potential of ejaculate and cause dependence (if you abuse stimulant drugs, one day an erection may simply not come). This is a crime against yourself. There is no need to risk health (and sometimes life). If you take ED medication in the recommended doses and do not abuse it, it won’t harm your health in any way!

The Effects of Viagra on the Body
The Effects of Viagra on the Body

The Effects of Viagra on the Body

Viagra is a powerful drug that increases blood flow to the penis so you can get and maintain an erection. It’s effective, but it can also cause some side effects.

Viagra is a brand-name version of the generic drug sildenafil. It’s a phosphodiesterase type 5 (PDE5) inhibitor. PDE5 is an enzyme that regulates certain chemicals in your blood, but as a result can make it harder for you to get and keep an erection.

Viagra is used to treat erectile dysfunction (ED). While it helps you temporarily maintain an erection so you can have sex, it doesn’t cure ED. It doesn’t affect sexual desire either. You still need mental or physical stimulation to get an erection.

This medication is only available with a doctor’s prescription.

Circulatory system

It takes a finely choreographed series of events to produce an erection. It begins with arousal signals from your brain, and it all hinges on good blood flow to the penis.

Within the penis are two chambers called the corpora cavernosa. Nitric oxide (NO) is released in the chambers during sexual stimulation. NO activates an enzyme called guanylate cyclase. That increases levels of cyclic guanosine monophosphate (cGMP), which causes muscles to relax.

The chambers also contain a network of blood vessels. When those blood vessels relax and widen, blood rushes in. The resulting pressure is what causes an erection.

PDE5 can dampen the effect of cGMP. Viagra works by inhibiting PDE5.

Viagra is rapidly absorbed into the bloodstream. Maximum concentrations are reached within about an hour.

One of the more common side effects is flushing, or redness.

This medication can also cause a decrease in blood pressure, particularly one to two hours after taking it. If you already have low blood pressure, discuss the pros and cons of Viagra with your doctor.

For most people, sexual activity is good for cardiovascular health. However, if you have cardiovascular disease, you should ask your doctor if it’s safe for you to take Viagra. You should also avoid Viagra if your doctor advised you not to have sex.

You shouldn’t take Viagra if you’ve had a stroke or heart attack or if you have unstable angina.

Certain drug interactions can harm your heart. Avoid taking PDE5 inhibitors if you also use long-lasting alpha-blockers or take medications that contain nitrates.

Reproductive system

Viagra can be quite effective, but it’s no magic pill. It does nothing for the libido. You still need some kind of stimulation to get an erection.

The effects of Viagra usually last about 4 hours, though they may last longer for some men. A rare, but serious side effect, is priapism. That’s when you get an erection that lasts for a long period of time. It can become quite painful.

If you have an erection that lasts for more than 4 hours, seek immediate medical attention.

You should also be wary of PDE5 inhibitors if you have an anatomical abnormality of the penis. If you have Peyronie’s disease, your doctor may advise against taking Viagra.

Viagra is a temporary fix and doesn’t cure ED. It offers no protection from sexually transmitted infections (STIs).

Central nervous system

Viagra helps to improve blood flow to the penis, but your brain is still your most valuable sex organ. Viagra won’t work if you’re not in the mood.

Some potential side effects of Viagra are headache and a runny or blocked nose, or a nosebleed. Some men feel lightheaded or dizzy. In rare cases, Viagra can cause fainting. Some men taking PDE5 inhibitors report back or muscle pain.

It’s not common, but some men experience ringing in the ears, hearing loss, or vision loss after taking PDE5 inhibitors.

Avoid PDE5 inhibitors if you have a history of an eye condition called non-arteritic anterior ischemic optic neuropathy (NAION). NAION is characterized by the interruption of blood flow to the optic nerve.

If you have hearing or vision loss while taking Viagra, seek immediate medical help.

Excretory and digestive system

Viagra is dispensed in a film-coated tablet. You can take Viagra with or without food, and it’s best to take it about an hour before you plan to have sex.

Don’t take Viagra more than once per day.

About 80 percent of Viagra leaves your body in your feces. The rest is washed out with your urine.

One fairly common side effect of Viagra is indigestion or stomach upset. PDE5 inhibitors can sometimes cause nausea or vomiting.

How Viagra Works ?

Since the debut of the erectile dysfunction drug Viagra (sildenafil) in 1998, millions of men have discovered how this medication can help treat the symptoms of erectile dysfunction.

Viagra is used to treat Erectile Dysfunction (ED) and Pulmonary Arterial Hypertension (PAH). It contains the active ingredient, Sildenafil. It works by relaxing the blood vessel walls, allowing blood flow to the penis more easily, which is an essential factor in getting and maintaining an erection.

Viagra is a blue, diamond-shaped tablet that comes in doses of 25mg, 50mg or 100mg.

You should follow the advice of a doctor when taking this medication. It is possible to buy it online without a prescription, but this is risky as the ingredients may be harmful, so we advise you to consult a doctor before taking Viagra. They will advise you on the correct dosage and whether any other medication you are taking may interfere with its effectiveness.

After taking the medication you should expect to see an effect after about 30 minutes. You will need to be sexually aroused in order for it to take effect.

But while countless men around the world (and their partners) have experienced the clear benefits of Viagra in their sex lives, there’s not as much awareness of how the “little blue pill” actually works. What does Viagra really do in the human body?

How fast does it work, and how long does it last? We decided to dig deeper and find out. If you’ve ever been curious about what Viagra can do, read on – you might be surprised at what you discover.

The manufacturers of Viagra recommend taking Viagra one hour before having sex. However, studies have suggested that it could start working even sooner than that. Some men were able to achieve an erection just 12 minutes after taking Viagra, although this wasn’t conclusively proven to be due to Viagra.

And while the maximum concentration of sildenafil in the blood isn’t reached until about an hour after taking it (and is potentially delayed by an additional hour if taken with food), it took a median of 27 minutes (with a range of 12–70 minutes) for men taking sildenafil to begin experiencing erections.

This was 23 minutes sooner than the median time of 50 minutes experienced by those who took a placebo.

The half-life of Viagra in the body is about four hours, meaning that every four hours after taking it, there’s only half as much of the drug left. However, even 10 to 12 hours after taking Viagra, men could still often achieve erections hard enough for penetration, though of a shorter duration. By 24 hours, all traces of Viagra in the blood are practically gone.

We’ve seen how quickly Viagra can work – but once it starts working, how long do erections typically last? In one study, an hour after taking Viagra, men reported being able to achieve erections lasting an average of 33 minutes. After eight hours, this decreased to 23 minutes, and by 12 hours, the mean duration of erections was reported to be 16 minutes.

In comparison, men who took a placebo found that they experienced erections lasting an average of seven minutes – less than half as long as among men who had taken Viagra 12 hours ago. Even long after the window of 30 minutes to four hours recommended by the manufacturers of Viagra, the drug clearly still has possible beneficial effects on erectile function.

Viagra is clearly an effective medication for some men, but how does it work on a cellular level? The mechanism by which Viagra allows men to achieve an erection more easily is fascinating. By inhibiting an enzyme known as PDE5 associated with muscle contraction in penile tissue, Viagra allows blood vessels to relax and expand, leading to increased blood flow into the penis.

So how do these molecular-level effects translate into bedroom performance? A study of nearly 4,000 men with erectile dysfunction who were then treated with sildenafil found a clear increase in the firmness of erections. Prior to taking Viagra, 58.7% of these men reported an erection hardness score of only 1 or 2, considered insufficient for penetration. However, after four weeks of treatment, 96.3% found they were able to obtain erections of hardness grade 3 or 4 – with 63.6% achieving grade 4 erections, the highest possible firmness. Without Viagra, a majority of these men would have had great difficulty having sex.

While Viagra was the first PDE5-inhibiting erectile dysfunction drug to be brought to market, a number of similar medications have since made their debut, such as Cialis, Levitra, and Spedra. But how do all these competing medications stack up? In a review of 82 trials covering over 47,000 patients, Viagra in a dose of 50mg was found to have a greater measured efficacy than all other PDE5-inhibiting medications when they were compared with a placebo.

Seeking Help for Your Sex Life

Viagra has achieved such widespread recognition and usage that it’s practically become synonymous with erectile dysfunction treatment. And while this has led to greater openness on the subject of impotence and sexual performance issues, discussion of sexual difficulties can still be a challenging topic for many. If you’ve been struggling with erectile dysfunction, visit Onlinedoctor.Superdrug.com for a discreet consultation with qualified medical professionals. You can receive expert advice in the comfort and privacy of your home, with any treatments quickly shipped to your door.

Sources

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Education and Communication and other Non-surgical Treatments for Erectile Dysfunction (ED)?

Education and communication

Education about sex, sexual behaviors, and sexual responses may help a man overcome his anxieties about sexual dysfunction.

Talking honestly with your partner about your needs and concerns may also help to overcome many barriers to a healthy sex life.

Medication

Medications such as

    • sildenafil (Viagra®),
    • vardenafil (Levitra®),
    • or tadalafil (Cialis®)

may help improve sexual function in men by increasing blood flow to the penis. Men who are on medicines that contain nitrates such as nitroglycerine should not take oral ED medications. The combination of nitrates and these specific medications can cause low blood pressure (hypotension).

The most common side effects of these medications are indigestion, nasal congestion, flushing, headaches and a temporary visual disturbance.

Mechanical aids

Aids such as vacuum devices and penile constriction rings serve as erectile aids for some men.

A vacuum constriction device (above) is a cylinder that is placed over the penis. The air is pumped out of the cylinder, which draws blood into the penis and causes an erection. The erection is maintained by slipping a band off of the base of the cylinder and onto the base of the penis. The band can stay in place for up to 30 minutes. The vacuum device can be safely used to treat most causes of erectile failure. Lack of spontaneity, discomfort, and cumbersomeness of the device seem to be the biggest concerns of patients.

Figure 3. Choosing an injection site

Penile injection therapy (intracavernosal injection therapy)

Men are taught how to inject medications directly into the erection chambers of the penis to create an erection. Injection therapy is effective in treating a wide variety of erection issues caused by blood vessel, nerve and psychological conditions.

The tissue that causes you to get an erection (erectile tissue) is a muscle. Going long periods of time without an erection is unhealthy for erectile tissue and may damage it.

We believe that having erections keeps erectile tissue healthy. A penile injection helps you have an erection. It works best if it’s given about 5 to 15 minutes before you want an erection.

Using a tiny needle and syringe, the man injects a small amount of medicine into the side of his penis. The medicine relaxes the blood vessels, allowing blood to flow into the penis. This treatment has been widely used and accepted since the early 1980s. The three most common medicines are prostaglandin E1 (alprostadil), papaverine (Papacon®), and phentolamine (Regitine®).

The most common side effects are pain and penile scarring (fibrosis). In extremely rare cases, patients with cerebral and vascular disease or severe cardiovascular diseases might not be able to tolerate the dizziness and high blood pressure occasionally caused by injection therapy.

A painful erection that lasts longer than two to three hours is called priapism and may occur with injection therapy. This can be lessened with proper dosing and by following the treatment guidelines.

The 3 most commonly used medications for injection therapy are Trimix, Bimix, and Papaverine. Most men begin injection therapy with Trimix, which is a mixture of 3 ingredients: alprostadil, phentolamine, and papaverine. These ingredients work by relaxing the smooth muscle and opening the blood vessels in your penis, causing an erection. Your APP will decide whether Trimix or a different medication is best for you.

 

Psychology and sex therapies

Psychological causes may contribute to erectile failure even when there is a clear organic cause.

Therapy with a trained counselor can help a person address feelings of anxiety, fear or guilt that may have an impact on sexual dysfunction.

Sex therapy can be beneficial to most men when counseling is provided by a skilled sex therapist. Sex therapy also helps a man’s partner accept and cope with the problems.

A patient whose ED has a clear psychological cause should receive sex therapy counseling before any invasive treatments are pursued.

When you seek out sex therapy, you need to look for a relationship or marriage counsellor, psychotherapist or psychologist who uses specialised clinical skills and theoretical knowledge about human sexuality. In addition to having post-graduate training in couples and marriage counselling, we get specific sex therapy training to help you deal with your sexual difficulties or concerns.

Sex therapists are qualified counsellors or healthcare professionals who have had extensive training in human sexuality, in addition to being well-trained couples and marriage counsellors and therapists.

Sexual issues can often cause distress and conflict in relationships and sex therapists can assist you with these difficulties.

Some sexual concerns include:

      • Lack of sexual knowledge or education
      • Believing wrong/harmful information about sex from the media or religious institutions
      • Struggle to understand sex, desire, eroticism, privacy versus secrecy
      • Erectile and/or ejaculation difficulties
      • Performance anxiety and lack of confidence
      • Problems reaching orgasm
      • Low sexual desire concerns for both men and women
      • Intimacy problems
      • Relationship and marriage difficulties
      • Painful sex or intercourse
      • Sexual problems or changes due to illness, ageing, surgery or stress
      • Compulsive sexual behaviours, or out of control sexual behaviours (wrongly called sexual addiction)
      • Sexual trauma
      • Questioning your sexual identity, orientation or preferences
      • LGBTQI issues
      • Gender identity issues
      • Interest in kink
      • Cross dressing or other fetishes

Hormone

Low hormone levels may play a role in ED. Hormone replacement in the form of topical gels, creams, patches, injections and pellets are only used after physician evaluation.

Buy Viagra Online

Sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis) and avanafil (Stendra) are oral medications that reverse erectile dysfunction by enhancing the effects of nitric oxide, a natural chemical your body produces that relaxes muscles in the penis.

This increases blood flow and allows you to get an erection in response to sexual stimulation.

What is Viagra (sildenafil)?

Sildenafil (Viagra) is used to treat erectile dysfunction (impotence; inability to get or keep an erection) in men. Sildenafil (Revatio) is used to improve the ability to exercise in adults with pulmonary arterial hypertension (PAH; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness). Children should not usually take sildenafil, but in some cases, a doctor may decide that sildenafil (Revatio) is the best medication to treat a child’s condition.

Sildenafil is in a class of medications called phosphodiesterase (PDE) inhibitors. Sildenafil treats erectile dysfunction by increasing blood flow to the penis during sexual stimulation. This increased blood flow can cause an erection. Sildenafil treats PAH by relaxing the blood vessels in the lungs to allow blood to flow easily.

How does Viagra work?

Viagra works by increasing blood flow to your penis. It’s a reliable treatment for men who are unable to achieve an erection and those unable to maintain an erection. If you’re struggling with erectile dysfunction, this might be the right ED medicine for you.

So what exactly does Viagra do? By relaxing the arteries and muscles in the penis, this medication helps increase blood flow to the area. When you experience sexual arousal after taking this medicine, blood flows through the relaxed arteries to your penis, allowing you to achieve and maintain an erection. But don’t worry, you won’t get a spontaneous erection just from taking a pill. You have to be sexually aroused after taking this medicine to get an erection.

Viagra is the most popular branded medication on the market for erectile dysfunction and has helped many men suffering from ED. Need help figuring out which is the right ED med for you? Schedule an easy online appointment with one of our doctors or nurse practitioners right now. We know how much privacy and discretion matter when it comes to your sexual health.

That’s why we offer convenient video appointments with medical professionals from the comfort of your own home and ability to message our medical team anytime. Plus, our online pharmacy will deliver meds to your door in discreet packaging in just 2-3 days. We’ve got you covered.

How should Viagra be used?

Sildenafil comes as a tablet and suspension (liquid; Revatio only) to take by mouth.

If you are taking sildenafil to treat erectile dysfunction, follow your doctor’s directions and the guidelines in this paragraph. Take sildenafil as needed before sexual activity. The best time to take sildenafil is about 1 hour before sexual activity, but you can take the medication any time from 4 hours to 30 minutes before sexual activity. Sildenafil usually should not be taken more than once every 24 hours. If you have certain health conditions or are taking certain medications, your doctor may tell you to take sildenafil less often. You can take sildenafil with or without food. However, if you take sildenafil with a high-fat meal, it will take longer for the medication to start to work.

If you are taking sildenafil to treat PAH, follow your doctor’s directions and the guidelines in this paragraph. You will probably take sildenafil three times a day with or without food. Take sildenafil at around the same times every day, and space your doses about 4 to 6 hours apart.

Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take sildenafil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Shake the liquid well for 10 seconds before each use to mix the medication evenly. Use the oral syringe provided with your medication to measure and take your dose. Follow the manufacturer’s directions to use and clean the oral syringe. Do not mix the liquid with other medications or add anything to flavor the medication.

If you are taking sildenafil for erectile dysfunction, your doctor will probably start you on an average dose of sildenafil and increase or decrease your dose depending on your response to the medication. Tell your doctor if sildenafil is not working well or if you are experiencing side effects.

If you are taking sildenafil for PAH, you should know that sildenafil controls PAH but does not cure it. Continue to take sildenafil even if you feel well. Do not stop taking sildenafil without talking to your doctor.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

What are the risks and warnings for Viagra (sildenafil)?

Viagra (sildenafil) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options

RISK OF HEART ATTACK OR STROKE

  • Risk factors: Existing heart condition | Recent heart attack or stroke in past 6 months | High or low blood pressure

It’s not recommended for men to take Viagra (sildenafil) if they’ve had a heart attack, stroke, or symptoms of heart failure in the past 6 months, abnormal blood pressure, or if they have chest pain. The safety of Viagra (sildenafil) has not been studied in these situations. Talk to your doctor if you have any of these health conditions.

LOW BLOOD PRESSURE

  • Risk factors: Taking alpha blockers | Taking medications for high blood pressure or chest pain (angina) | Drinking alcohol

If you’re taking alpha blockers or medications for high blood pressure with Viagra (sildenafil), your blood pressure may drop too low. Make sure to check your blood pressure regularly if you’re taking these other medicines. Be very careful getting up from a sitting or lying down position since this can make you feel dizzy and more likely to fall. Drinking alcohol can also cause low blood pressure. Avoid or lower your alcohol consumption when taking Viagra (sildenafil). You should never take Viagra (sildenafil) when taking nitrate medication for chest pain (angina) because it can cause your blood pressure to suddenly drop to unsafe levels.

PROLONGED ERECTION
  • Risk factors: Peyronie’s disease | Cavernosal fibrosis | Sickle cell anemia

There have been reports of men having an erection lasting more than 4 hours while on Viagra (sildenafil). This is rare but if it’s not treated in time, it can cause permanent damage to your penis, including permanent impotence. Get medical help immediately if this happens.

VISION CHANGES

If you suddenly notice changes in your vision in one or both eyes, go to the emergency room or call your doctor immediately. Although this is rare, Viagra (sildenafil) can cause permanent eye damage.

HEARING LOSS

There have been reports of men having permanent hearing loss while taking Viagra (sildenafil). This may happen along with ringing in the ears (tinnitus) and dizziness. Go to the emergency room or call your doctor immediately if you notice changes in your hearing in one or both ears.

INCREASED SIDE EFFECTS WITH OTHER MEDICINES
  • Risk factors: Age 65 years or older | Liver disease | Kidney disease | Taking medications such as nitrates, anti-hypertensives, alpha blockers, ketoconazole, or ritonavir

You may experience more side effects while taking Viagra (sildenafil) if you are also taking medications called nitrates for chest pain, blood pressure medications, certain medications for HIV, are elderly, or have liver or kidney disease. Talk to your doctor before starting Viagra (sildenafil) if any of these apply to you.

How to take Viagra

Take 1 Viagra pill one hour before sex. Never take more than one pill on the same day.

Grapefruit can increase the risk that you experience side effects, so don’t eat grapefruit or drink grapefruit juice on the same day as using Viagra.

Take this medication only as needed. The usual starting dosage is 50mg but your doctor or nurse practitioner might start you on a different dose based on your unique medical history. This medication isn’t suitable for everyone and shouldn’t be taken if you’re also on a nitrate drug for heart problems. If you’re struggling with ED as well as a heart condition, please consult with a doctor or nurse practitioner before taking this medication.

Wondering when to take Viagra? Take it an hour or so before you plan to have sex since this medicine takes at least 30-60 minutes of taking it for it to work. If you have any other questions about how to take Viagra, our medical team is available and ready to answer them.

 

Viagra vs Sildenafil

Viagra and sildenafil are medically the same, containing the same active ingredient sildenafil. The main difference is price where generic sildenafil is cheaper than branded Viagra (sold by Pfizer). Also, sildenafil is available in 20mg dosage. Viagra comes in diamond shaped blue pills and sildenafil comes in white or blue tablets. Both are equally effective for the treatment of erectile dysfunction.

Viagra side effects

Sildenafil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
  • headache
  • heartburn
  • diarrhea
  • flushing (feeling of warmth)
  • nosebleeds
  • difficulty falling asleep or staying asleep
  • numbness, burning, or tingling in the arms, hands, feet, or legs
  • muscle aches
  • changes in color vision (seeing a blue tinge on objects or having difficulty telling the difference between blue and green)
  • sensitivity to light
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:
  • sudden severe loss of vision (see below for more information)
  • blurred vision
  • sudden decrease or loss of hearing
  • ringing in ears
  • dizziness or lightheadedness
  • fainting
  • chest pain
  • worsening shortness of breath
  • erection that is painful or lasts longer than 4 hours
  • itching or burning during urination
  • rash

Some patients experienced a sudden loss of some or all of their vision after they took sildenafil or other medications that are similar to sildenafil. The vision loss was permanent in some cases. It is not known if the vision loss was caused by the medication. If you experience a sudden loss of vision while you are taking sildenafil, call your doctor immediately. Do not take any more doses of sildenafil or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor.

There have been reports of heart attack, stroke, irregular heartbeat, bleeding in the brain or lungs, high blood pressure, and sudden death in men who took sildenafil for erectile dysfunction. Most, but not all, of these people had heart problems before taking sildenafil. It is not known whether these events were caused by sildenafil, sexual activity, heart disease, or a combination of these and other causes.Talk to your doctor about the risks of taking sildenafil.

Some patients experienced a sudden decrease or loss of hearing after they took sildenafil or other medications that are similar to sildenafil. The hearing loss usually involved only one ear and did not always improve when the medication was stopped. It is not known if the hearing loss was caused by the medication. If you experience a sudden loss of hearing, sometimes with ringing in the ears or dizziness, while you are taking sildenafil, call your doctor immediately. If you are taking sildenafil (Viagra) for erectile dysfunction, do not take any more doses of sildenafil (Viagra) or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor. If you are taking sildenafil (Revatio) for PAH, do not stop taking your medication until you talk to your doctor.

Sildenafil may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

 

Buying oral erectile dysfunction medications online

Treatments for erectile dysfunction are big business, and online scams abound. If you do buy medications over the internet:

  • Check to see if an online pharmacy is legitimate. Never order medications from an online pharmacy if there’s no way to contact the pharmacy by phone, if prices seem too good to be true or if you’re told no prescription is necessary. Some illegal businesses sell counterfeit versions of legitimate medications, which can be ineffective or dangerous. In the U.S., the National Association of Boards of Pharmacy can tell you whether an online pharmacy is licensed and in good standing.
  • Make sure you get the right prescription and dose. When you order medications — and when you receive them in the mail — make sure they’re the exact dose and type prescribed by your doctor.
  • Don’t be fooled into buying ‘herbal viagra.’ Never take any medications that claim to be the “herbal” or nonprescription equivalent of an oral medication for erectile dysfunction. These aren’t an effective alternative, and some contain harmful substances.

Interactions between Viagra (sildenafil) and other medications

Viagra (sildenafil) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Viagra (sildenafil). Please note that only the generic name of each medication is listed below.

 

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amprenavir
  • Amyl Nitrite
  • Atazanavir
  • Boceprevir
  • Cobicistat
  • Darunavir
  • Erythrityl Tetranitrate
  • Fosamprenavir
  • Indinavir
  • Isosorbide Dinitrate
  • Isosorbide Mononitrate
  • Lopinavir
  • Molsidomine
  • Nelfinavir
  • Nitroglycerin
  • Nitroprusside
  • Pentaerythritol Tetranitrate
  • Propatyl Nitrate
  • Riociguat
  • Ritonavir
  • Saquinavir
  • Telaprevir
  • Tipranavir

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Cannabis
  • Ceritinib
  • Clarithromycin
  • Conivaptan
  • Dihydrocodeine
  • Duvelisib
  • Fluconazole
  • Fosnetupitant
  • Idelalisib
  • Itraconazole
  • Ivosidenib
  • Larotrectinib
  • Lefamulin
  • Lorlatinib
  • Lumacaftor
  • Nefazodone
  • Netupitant
  • Simeprevir
  • Telithromycin
  • Voriconazole

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alfuzosin
  • Bosentan
  • Bunazosin
  • Ciprofloxacin
  • Delavirdine
  • Doxazosin
  • Erythromycin
  • Etravirine
  • Ketoconazole
  • Moxisylyte
  • Nebivolol
  • Prazosin
  • Rifapentine
  • Silodosin
  • Tamsulosin
  • Terazosin
  • Trimazosin

How to use Viagra ?

Read the Patient Information Leaflet provided by your pharmacist before you start taking sildenafil and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

To treat erectile dysfunction-ED, take this drug by mouth as directed by your doctor, usually as needed. Take sildenafil at least 30 minutes, but no more than 4 hours, before sexual activity (1 hour before is the most effective). Do not take more than once daily.

A high-fat meal may delay how quickly the drug begins to work.

The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Tell your doctor if your condition does not improve Buy Viagra 100mg Online

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Which Drugs are Good for Erectile Dysfunction?

What are the differences between erectile dysfunction drugs? About half of men ages 40 to 70 have erectile dysfunction (ED) to some degree, although only one in 10 report a complete inability to have erections. Taking an ED drug produces an erection sufficient to start intercourse in about 70% of otherwise healthy men.

Does it make any difference which of the four drugs for erectile dysfunction you take? “Yes, there can be differences,” says Dr. Louis Liou, chief of urology at Harvard-affiliated Cambridge Health Alliance in Boston. “For new patients, I have them try different ones to see what works best.”

Sildenafil (Viagra) is often the first drug your doctor offers. It’s been on the market longest and its side effects and the medications and foods it interacts with are well known.

But the main challenge to finding the best ED drug for you may turn out to be health insurance rules—not biochemistry. It’s a common practice among insurers to limit the number of pills you can obtain per month. After you hit your limit, the out-of-pocket cost for a single pill can be very high. “The main obstacle in my practice is the cost,” Dr. Liou says. You’ll need to work with your doctor to get the pill you need at a price you can afford.

What erectile dysfunction pills are available?

In addition to Viagra, other ED drugs available in the United States include avanafil (Stendra), tadalafil (Cialis) and vardenafil (Levitra). These all improve blood supply to the penis. In combination with sexual stimulation, the drugs can produce an erection sufficient to initiate and complete intercourse.

There is also a fast-dissolving form of Levitra, called Staxyn, that you put under your tongue.

  • Viagra
  • Cialis
  • Levitra

One ED drug, Cialis, is FDA-approved for use daily in a dose of 2.5 or 5 milligrams. This helps to produce erections on demand and may also help relieve urinary problems, like difficulty starting urination, that result from an enlarged prostate.

 

How well do ED pills work?

ED drugs produce an erection sufficient for intercourse in about 70% of men. But the results vary quite a bit from one individual to another. A man with nerves or arteries damaged by prostate surgery, diabetes, or cardiovascular disease will not respond as strongly to ED drugs. “There are some men in whom none of these drugs work,” Dr. Liou says.

 

How quickly do ED pills work?

How soon the drugs start working ranges from 15 to 60 minutes. Neither Viagra nor Levitra will work if you take them after a meal, which blocks their absorption. However, neither Cialis nor Stendra interact with food this way. The onset time determines how soon you can engage in intercourse. Stendra and daily-use Cialis are closest to being an “on demand” erectile drug; using the others requires more planning.

 

How to use ED pills properly

Dr. Liou says that some men come to him after getting a prescription from their primary care doctors, claiming that the drug doesn’t work. Sometimes it’s because they used it incorrectly. “The biggest misconception is that these drugs are an on/off switch for erections,” Dr. Liou says. But the drugs don’t work well without sexual stimulation. “During that time, you need to be with your partner and have foreplay,” Dr. Liou says. “Don’t take it, do the taxes or the dishes, and then meet at the bedroom thinking you’ll be ready to go. It’s not like that.”

 

How long do ED pills last?

The ED drugs break down at different rates in the body. The durations of action range from four hours to more than a day (for Cialis in the higher doses). Each dose should be sufficient to provide a full cycle of intercourse, from erection to climax.

“Will it last through another cycle? It’s not guaranteed,” Dr. Liou says. To have sex more than once a day, Cialis is your best bet.

 

What are the side effects of ED pills?

The most common side effects of ED drugs, in order of most to least common are headache, flushing, upset stomach, nasal congestion, vision problems, diarrhea, dizziness, and rash. A man who has an erection that lasts four hours or more needs to get to a hospital or risk permanent damage.

None of the ED drugs is safe to take with cardiac drugs called nitrates because it could cause a dangerous drop in blood pressure. Drugs that many men take for urinary symptoms, called alpha blockers, can also lower blood pressure, so take them at least four hours apart from ED drugs. Your doctor may start you on a smaller dose of the ED drug if you already take an alpha blocker or may recommend the alpha blocker tamsulosin (Flomax), which affects blood pressure less.

 

Heart health and erectile dysfunction

ED is often an early warning sign of underlying cardiovascular disease, such as clogged arteries (atherosclerosis). “It can predate a diagnosis of cardiovascular disease by at least a few years,” Dr. Liou says. We don’t have strong proof yet that starting to live a healthier lifestyle can reverse erectile problems, but it can’t hurt.

 

ED drugs: How soon they start working and how long they last

Medication Onset Duration
avanafil (Stendra) 15-30 minutes 6-12 hours
sildenafil (Viagra) 30-60 minutes 4-5 hours
tadalafil (Cialis) 30-45 minutes 24-36 hours
tadalafil (Cialis) daily continuous continuous
vardenafil (Levitra) 30-60 minutes 4-5 hours

Looking for natural solutions to ED?

Best Alternatives to Viagra: Treatments That Last Longer and What is the Difference Between Cialis and Viagra ?

Viagra is the most popular medication for erectile dysfunction. It was the first medicine approved to treat ED in 1998. It works quickly and can be used to treat men of all age groups. If you cannot use this drug for some reason or just want to try similar medications, you should know that there are good alternatives to sildenafil.

Cialis is the best analogue of Viagra, which has won an excellent reputation among men. The main active ingredient of Cialis is tadalafil, which, like sildenafil, belongs to the category of PDE5 inhibitors. Tadalafil causes an active blood flow to the perineum and penis of a man, due to which a good persistent erection occurs. The drug works only in the presence of natural stimulation, instantly increasing libido and sexual desire. Many men prefer Cialis because this is an ultra-long-acting ED drug – its duration is up to 36 hours;

Levitra is another worthy substitute for Viagra. The main active ingredient of Levitra is vardenafil, This drug is ideal for the symptomatic treatment of male sexual impotence. This medicine, like other drugs for improving potency, is prescribed by the doctor on an individual basis after a thorough examination. Levitra lasts about 8-12 hours and, unlike Viagra, is compatible with alcohol

Stendra is one more medication used to treat erectile dysfunction. It contains the active ingredient avanafil. It has a quick onset of action in comparison to other ED drugs available and starts working just 15 minutes after taking the pill. It is one of the newest drugs to be released for ED. Avanafil remains effective for 6 hours and may maintain benefits longer in some patients.

Compare the information about popular ED drugs in the table below:

Cialis vs. Viagra quick comparison

Cialis Generic
Cialis Generic
  • Cialis (tadalafil) and Viagra (sildenafil) are phosphodiesterase-5 (PDE5) inhibitors used for treating impotence (erectile dysfunction, or ED).
  • Adcirca is another brand name of tadalafil.
  • Common side effects of Cialis and Viagra that are similar include flushing (redness or warmth of the face, neck, or chest), headaches, stomach pain or upset, flu-like symptoms (such as stuffy nose, sneezing, or sore throat), memory problems, muscle or back pain, blurred vision and changes in color vision (such as an inability to differentiate between the colors green and blue), dizziness, diarrhea, nausea, low blood pressure, abnormal ejaculation, and prolonged erections (priapism), loss of hearing, and ringing in the ears.
  • One difference between the drugs is how long they stay in your system. Cialis provides penile hardness (the ability to obtain an erection) over a longer period than Viagra because it lasts up to 18 hours, while Viagra only lasts for about 4 to 6.

 

What are Cialis and Viagra?

 

Cialis (tadalafil) and Viagra (sildenafil) are oral drugs that are used for treating impotence (the inability to attain or maintain a penile erection) and benign prostatic hyperplasia (BPH). They are in a class of drugs called phosphodiesterase-5 (PDE5) inhibitors that also includes vardenafil (Levitra, Staxyn ODT), and avanafil (Stendra).

Penile erection is caused by the engorgement of the penis with blood. Under normal conditions, sexual stimulation leads to the production and release of nitric oxide in the penis. Nitric oxide then activates the enzyme, guanylate cyclase, which causes the production of cyclic guanosine monophosphate (cGMP). It is the cGMP that is primarily responsible for the erection by affecting the amount of blood that the blood vessels deliver and remove from the penis. Cialis and Viagra inhibit an enzyme called phosphodiesterase-5 (PDE5) which destroys the cGMP. Thus, Cialis and Viagra prevent the destruction of cGMP and allows cGMP to accumulate and persist longer. The longer cGMP persists, the more prolonged the engorgement of the penis.

What is the dosage of Cialis vs. Viagra?

 

Cialis

For most individuals, the recommended starting dose of tadalafil is 10 mg per day taken before sexual activity (tadalafil for use as needed).

Depending on the adequacy of the response or side effects, the dose may be increased to 20 mg or decreased to 5 mg a day. The effect of tadalafil may last up to 36 hours. Individuals who are taking medications that increase the blood levels of tadalafil should not exceed a total dose of 10 mg in 72 hours (See drug interactions). For once daily use without regard to sexual activity, the recommended dose is 2.5 to 5 mg daily. Tadalafil should not be taken more than once daily.

The recommended dose for BPH, or BPH and ED is 5 mg daily taken about the same time each day. Tadalafil may be taken with or without food since food does not affect its absorption from the intestine.

The dose of tadalafil may require adjustment for patients with reduced kidney or liver function.

Viagra

  • The usual recommended dose is 25 to 100 mg 1 hour before sexual activity.
  • The maximum dose is 100 mg daily.
  • The elderly (over 65 years of age) should start at 25 mg before sexual activity.
  • Sildenafil is rapidly absorbed. Maximum observed plasma concentrations are reached within 30 to 120 minutes (median 60 minutes) of oral dosing in the fasted state. When sildenafil is taken with a high fat meal, the rate of absorption is reduced, with an average delay in the time to maximal concentration of 1 hour.

What is the Common Side effects of Erectile Dysfunction Medicines ?

What is erectile dysfunction?

 

The malady formerly known as impotence, erectile dysfunction (ED) is the inability to get or maintain an erection sufficient for satisfying sex. That might include erections that don’t last as long as you want or aren’t as firm as you’d like. ED is very prevalent among American men: Experts estimate that more than 30 million American men have experienced these kinds of erection issues (Nunes, 2012).

What Is the Erectile dysfunction Medications ?

 

Erectile dysfunction (ED), also called impotence, can affect your quality of life by decreasing your satisfaction from sex. ED can have many causes, both psychological and physical. ED from physical causes is fairly common in men as they age. Medications are available that can help treat ED for many men.

The most well-known ED medications include:

  • tadalafil (Cialis)
  • sildenafil (Viagra)
  • vardenafil (Levitra)
  • avanafil (Stendra)

These prescription drugs increase the levels of nitric oxide in your blood. Nitric oxide is a vasodilator, meaning it makes your blood vessels widen to help increase the blood flow. These drugs are especially effective at widening the blood vessels in your penis. More blood in your penis makes it much easier for you to get and maintain an erection when you are sexually aroused.

However, these drugs can also cause side some effects. Here are seven of the most common side effects from ED medications.

 

Headaches

Headaches are the most common side effect associated with ED medications. The sudden change in blood flow from the increased levels of nitric oxide causes the headaches.

This side effect is common with all forms of ED medications, so switching brands won’t necessarily alleviate your symptoms. If you have headaches from your ED drug, talk to your doctor about how to prevent them.

Body aches and pains

Some people have muscle aches and pains throughout their bodies while taking ED medications. Others have reported specific pain in their lower back. If you have these types of pain while taking ED medication, over-the-counter (OTC) pain medication may help.

However, you should talk to your doctor about other possible causes of your pain. Your doctor can help you choose an OTC medication that is safe to take with your ED medications and with any other medications you take.

Digestive system problems

Your ED medication may cause uncomfortable digestive system side effects. The most common are indigestion and diarrhea.

To help relieve minor problems, consider making dietary changes to reduce upset stomach. Drinking water instead of caffeinated beverages, alcohol, or juice may help. If changing your diet doesn’t work, talk to your doctor about OTC remedies that may help.

Dizziness

An increase in nitric oxide can cause some men to become dizzy. The dizziness caused by ED medications is generally mild. However, any dizziness can cause discomfort during everyday activities.

In rare cases, dizziness from ED medications has led to fainting, which can become a serious health issue. You should tell your doctor if you experience dizziness while taking ED medications. If you faint while taking these medications, see your doctor right away.

Vision changes

ED medications can change the way you see things — literally. They can temporarily alter your eyesight and even cause blurry vision. ED medications aren’t recommended if you have had vision loss, or a retinal disorder called retinitis pigmentosa.

A complete loss of vision or changes that don’t go away can signify a more serious issue with your ED medication. Seek emergency medical care if you experience these symptoms.

Flushes

Flushes are temporary periods of redness of the skin. Flushes usually develop on your face and may also spread to parts of your body. Flushes can be mild, like blotchy skin, or severe, like rashes. Although the appearance may make you uncomfortable, flushes typically aren’t harmful.

Flushes from ED medications may get worse when you:

  • eat hot or spicy foods
  • drink alcohol
  • are outside in warm temperatures

Congestion and runny nose

Congestion or a runny or stuffy nose can be a common symptom of ED medications. In most cases, these side effects go away without treatment. Talk to your doctor if they persist.

Recognizing uncommon, severe side effects

Minor side effects are common when taking ED medication. Still, there are a few side effects that aren’t as common, and some can even be dangerous. Severe side effects of ED medications can include:

      • priapism (erections that last longer than 4 hours)
      • sudden changes in hearing
      • vision loss

Contact your doctor immediately if you have any of these severe side effects.

Certain men are more at risk of these side effects than others. This may be because of other conditions they have or other medications they take.

 

Serious side effects of ED medication

Go to the emergency room immediately if you experience any of the following symptoms or side effects:

      • Chest pain
      • Shortness of breath
      • Severe headaches
      • Fainting
      • Erections that last longer than four hours
      • Visual changes (like loss of sight)
      • Or anything out of the ordinary—even lightheadedness

If you notice any severe or prolonged symptoms at all, contact a healthcare provider immediately. It doesn’t matter how rare a side effect is if you’re the one experiencing it.

When discussing ED treatment with your doctor, it’s important to tell them about all drugs that you take and other health conditions you have. If ED drugs aren’t right for you, your doctor may suggest other treatment options, such as surgery or vacuum pumps.

What drugs interact with Cialis and Viagra?

Cialis

The breakdown and elimination of tadalafil from the body may be decreased by erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox), indinavir (Crixivan) and ritonavir (Norvir). Therefore, these drugs may increase the levels of tadalafil in the blood. If these drugs are being used at the same time as tadalafil, the dose of tadalafil should be reduced to 10 mg every 72 hours when used as needed or 2.5 mg when used daily in order to avoid side effects from high levels of tadalafil.

Rifampin, carbamazepine (Tegretol, Tegretol XR, Equerto, Carbatrol), phenytoin (Dilantin, Dilantin-125), and phenobarbital may decrease blood levels of tadalafil, possibly reducing the effect of tadalafil.

Tadalafil exaggerates the increases in heart rate and lowering of blood pressure caused by nitrates, for example, nitroglycerin, isosorbide dinitrate (Isordil), isosorbide mononitrate (Imdur, Ismo, Monoket), nitroglycerin (Nitro-Dur, Transderm-Nitro) that are used primarily for treating heart pain (angina). In patients who take nitrates for angina, tadalafil could cause heart pain or possibly even a heart attack by exaggerating the increase in heart rate and the lowering of blood pressure. Therefore, tadalafil should not be used with nitrates.

Tadalafil also exaggerates the blood pressure lowering effects of some alpha-blocking drugs for example, terazosin (Hytrin) that primarily are used for treating high blood pressure or enlargement of the prostate (BPH). Individuals who take these alpha-blockers should be on a stable dose of the alpha-blocker before tadalafil is started. In such situations, tadalafil should be started at the lowest dose. If the patient is already taking tadalafil, the alpha-blocker should be started at the lowest dose. Combining tadalafil with alpha-blockers for treatment of BPH is not recommended.

Tadalafil and alcohol both lower blood pressure. Therefore, combining tadalafil with alcohol may cause excessive drops in blood pressure and cause dizziness, headaches, and increased heart rate.

PDE5 inhibitors may affect platelet function and therefore prolong bleeding. Tadalafil should be used cautiously in patients with bleeding disorders or active ulcers. Tadalafil should not be combined with Adcirca (another form of tadalafil) or other PDE5 inhibitors, for example, vardenafil (Levitra) or sildenafil (Viagra, Revatio).

Viagra

Viagra increases the effects of the blood pressure lowering medications. It also increases the blood pressure lowering effects of nitrates, for example, isosorbide dinitrate (Isordil), isosorbide mononitrate (Imdur, Ismo, Monoket), nitroglycerin (Nitro-Dur, Transderm-Nitro) that are used primarily for treating angina. Patients taking nitrates should not receive Viagra.

Patients should not combine Viagra with other PDE5 inhibitors (for example, vardenafil [Levitra], tadalafil [Cialis]).

Cimetidine (Tagamet), erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox), atazanavir (Reyataz), and mibefradil (Posicor) can cause marked increases in the amount of Viagra in the body. Patients taking these medications should be observed carefully if sildenafil is used.

It is expected that rifampin will decrease blood levels of Viagra and probably reduce its effectiveness.

Viagra can Make your Penis Harder and Save your Penis from Injury as well

It’s no secret that Viagra makes your penis harder for penetrative sex. But what you might not know is that it can save your penis from injury — if you start taking it early enough.

If you’re experiencing erectile dysfunction but wait to talk to your doctor until you can’t achieve an erection hard enough for penetrative sex, you may damage your penis. Having sex with an erection that’s barely “hard enough” can bend it and tear tissues that may scar as they heal, Dr. Montague says.

Scar tissue isn’t elastic like healthy penile tissue, so it will force your penis to bend with future erections, creating a condition known as Peyronie’s disease.

This affects 9 percent of men between the ages of 40 and 75. Many of these men have what Dr. Montague calls erectile insufficiency — erections that are not as firm as they used to be. During intercourse, bending may damage the penis. Taking Viagra could help prevent the problem and avoid an injury with lifelong consequences, he says.

No matter what your concern is, talk with your doctor. “If you’re having erectile dysfunction problems, you should feel confident going to your doctor. It’s a common issue,” Dr. Montague says. “Many men are embarrassed, but they shouldn’t be. Help is available, and it’s worth a try.”

What you should know before you take viagra ?

Don’t drink alcohol after taking

If you like a glass of wine or another alcoholic bev to unwind before sexy time, you should be fine.

But drinking more than that after taking Viagra could put a major damper on your rendezvous.

Moderate to heavy drinking can make it — er — harder for you to get an erection. Also, Viagra can lower blood pressure. Combining it with alcohol can increase this effect.

If your blood pressure drops, symptoms like dizziness, lightheadedness, and headache could also hinder your hard-on and mood.

How does the time frame compare with other ED meds?

Like Viagra, most ED drugs can be taken 30 to 60 minutes before sex.

The exception is Stendra (avanfil), which is the fastest-acting ED medication available. It only takes 15 to 30 minutes to kick in, depending on the dose.

When it comes to duration, Cialis (tadalafil) is the longest lasting and works for up to 36 hours.

What is Erectile Dysfunction and Why I Get ED ?

Erectile dysfunction (impotence) is the inability to get and keep an erection firm enough for sex.

Having erection trouble from time to time isn’t necessarily a cause for concern. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems. Problems getting or keeping an erection can also be a sign of an underlying health condition that needs treatment and a risk factor for heart disease.

If you’re concerned about erectile dysfunction, talk to your doctor — even if you’re embarrassed. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. In other cases, medications or other direct treatments might be needed.

Flaccid and erect penis

 

Symptoms

Erectile dysfunction symptoms might include persistent:

  • Trouble getting an erection
  • Trouble keeping an erection
  • Reduced sexual desire

 

Why I get Erectile Dysfunction ?

Depression – The brain is an often-overlooked erogenous zone. Sexual excitement starts in your head and works its way down. Depression can dampen your desire and can lead to erectile dysfunction. Ironically, many of the drugs used to treat depression can also suppress your sex drive and make it harder to get an erection, and they can cause a delay in your orgasm.

Alcohol – You might consider having a few drinks to get in the mood, but overindulging could make it harder for you to finish the act. Heavy alcohol use can interfere with erections, but the effects are usually temporary. The good news is that moderate drinking — one or two drinks a day — might have health benefits like reducing heart disease risks. And those risks are similar to erectile dysfunction risks.

Medications – The contents of your medicine cabinet could affect your performance in the bedroom. A long list of common drugs can cause ED, including certain blood pressure drugs, pain medications, and antidepressants. But do not stop taking any medicines without talking to your doctor first. Street drugs like amphetamines, cocaine, and marijuana can cause sexual problems in men, too.

Stress – It’s not easy to get in the mood when you’re overwhelmed by responsibilities at work and home. Stress can take its toll on many different parts of your body, including your penis. Deal with stress by making lifestyle changes that promote well-being and relaxation, such as exercising regularly, getting enough sleep, and seeking professional help when appropriate.

Anger – Anger can make the blood rush to your face, but not to the one place you need it when you want to have sex. It’s not easy to feel romantic when you’re raging, whether your anger is directed at your partner or not. Unexpressed anger or improperly expressed anger can contribute to performance problems in the bedroom.

Anxiety – Worrying that you won’t be able to perform in bed can make it harder for you to do just that. Anxiety from other parts of your life can also spill over into the bedroom. All that worry can make you fear and avoid intimacy, which can spiral into a vicious cycle that puts a big strain on your sex life — and relationship.

Middle-Aged Spread – Carrying extra pounds can impact your sexual performance, and not just by lowering your self-esteem. Obese men have lower levels of the male hormone testosterone, which is important for sexual desire and producing an erection. Being overweight is also linked to high blood pressure and hardening of the arteries, which can reduce blood flow to the penis.

Self-Image – When you don’t like what you see in the mirror, it’s easy to assume your partner isn’t going to like the view, either. A negative self-image can make you worry not only about how you look, but also how well you’re going to perform in bed. That performance anxiety can make you too anxious to even attempt sex.

Low Libido – Low libido isn’t the same as erectile dysfunction, but a lot of the same factors that stifle an erection can also dampen your interest in sex. Low self-esteem, stress, anxiety, and certain medications can all reduce your sex drive. When all those worries are tied up with making love, your interest in sex can take a nosedive.

Your Health – Many different health conditions can affect the nerves, muscles, or blood flow that is needed to have an erection. Diabetes, high blood pressure, hardening of the arteries, spinal cord injuries, and multiple sclerosis can contribute to ED. Surgery to treat prostate or bladder problems can also affect the nerves and blood vessels that control an erection.

 

Causes of Erectile Dysfunction

Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health concerns can cause or worsen erectile dysfunction.

Sometimes a combination of physical and psychological issues causes erectile dysfunction. For instance, a minor physical condition that slows your sexual response might cause anxiety about maintaining an erection. The resulting anxiety can lead to or worsen erectile dysfunction.

ED is not the same as premature ejaculation.

The major causes of ED include:

  • Vascular (blood vessel) disease — Erections happen when blood collects in the shaft of the penis. Vascular disease can limit the amount of blood flowing to or staying in the penis. Both can result in problems with erections.
  • Vascular disease is the most common medical cause of impotence.
  • Nerve damage — Nerves must be working normally for a man to get and keep an erection. Nerves can be damaged by diabetes, multiple sclerosis, prostate surgery or damage to the spinal cord.
  • Psychological factors — Psychological issues such as depression, anxiety, guilt or fear can sometimes cause sexual problems. At one time, these factors were thought to be the major cause of impotence. Doctors now know that physical factors cause impotence in most men with the problem. However, embarrassment or “performance anxiety” can make a physical problem worse.
  • Medications — Many medications cause problems with sexual function. These include drugs for high blood pressure, depression, heart disease and prostate cancer.
  • Hormonal problems — Abnormal levels of certain hormones can interfere with erections and sex drive. Hormonal problems, such as a low testosterone level, are an uncommon cause of impotence.

 

Physical causes of Erectile Dysfunction

In many cases, erectile dysfunction is caused by something physical. Common causes include:

  • Heart disease
  • Clogged blood vessels (atherosclerosis)
  • High cholesterol
  • High blood pressure
  • Diabetes
  • Obesity
  • Metabolic syndrome — a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol
  • Parkinson’s disease
  • Multiple sclerosis
  • Certain prescription medications
  • Tobacco use
  • Peyronie’s disease — development of scar tissue inside the penis
  • Alcoholism and other forms of substance abuse
  • Sleep disorders
  • Treatments for prostate cancer or enlarged prostate
  • Surgeries or injuries that affect the pelvic area or spinal cord
  • Low testosterone

Psychological causes of erectile dysfunction

The brain plays a key role in triggering the series of physical events that cause an erection, starting with feelings of sexual excitement. A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:

  • Depression, anxiety or other mental health conditions
  • Stress
  • Relationship problems due to stress, poor communication or other concerns

Risk factors

As you get older, erections might take longer to develop and might not be as firm. You might need more direct touch to your penis to get and keep an erection.

Various risk factors can contribute to erectile dysfunction, including:

  • Medical conditions, particularly diabetes or heart conditions
  • Tobacco use, which restricts blood flow to veins and arteries, can — over time — cause chronic health conditions that lead to erectile dysfunction
  • Being overweight, especially if you’re obese
  • Certain medical treatments, such as prostate surgery or radiation treatment for cancer
  • Injuries, particularly if they damage the nerves or arteries that control erections
  • Medications, including antidepressants, antihistamines and medications to treat high blood pressure, pain or prostate conditions
  • Psychological conditions, such as stress, anxiety or depression
  • Drug and alcohol use, especially if you’re a long-term drug user or heavy drinker

Complications

Complications resulting from erectile dysfunction can include:

  • An unsatisfactory sex life
  • Stress or anxiety
  • Embarrassment or low self-esteem
  • Relationship problems
  • The inability to get your partner pregnant

Prevention

The best way to prevent erectile dysfunction is to make healthy lifestyle choices and to manage any existing health conditions. For example:

  • Work with your doctor to manage diabetes, heart disease or other chronic health conditions.
  • See your doctor for regular checkups and medical screening tests.
  • Stop smoking, limit or avoid alcohol, and don’t use illegal drugs.
  • Exercise regularly.
  • Take steps to reduce stress.
  • Get help for anxiety, depression or other mental health concerns.

Diagnosis

For many people, a physical exam and answering questions (medical history) are all that’s needed for a doctor to diagnose erectile dysfunction and recommend a treatment. If you have chronic health conditions or your doctor suspects that an underlying condition might be involved, you might need further tests or a consultation with a specialist.

Tests for underlying conditions might include:

  • Physical exam. This might include careful examination of your penis and testicles and checking your nerves for sensation.
  • Blood tests. A sample of your blood might be sent to a lab to check for signs of heart disease, diabetes, low testosterone levels and other health conditions.
  • Urine tests (urinalysis). Like blood tests, urine tests are used to look for signs of diabetes and other underlying health conditions.
  • Ultrasound. This test is usually performed by a specialist in an office. It involves using a wandlike device (transducer) held over the blood vessels that supply the penis. It creates a video image to let your doctor see if you have blood flow problems.This test is sometimes done in combination with an injection of medications into the penis to stimulate blood flow and produce an erection.
  • Psychological exam. Your doctor might ask questions to screen for depression and other possible psychological causes of erectile dysfunction.

Treatment

The first thing your doctor will do is to make sure you’re getting the right treatment for any health conditions that could be causing or worsening your erectile dysfunction.

Depending on the cause and severity of your erectile dysfunction and any underlying health conditions, you might have various treatment options. Your doctor can explain the risks and benefits of each treatment and will consider your preferences. Your partner’s preferences also might play a role in your treatment choices.

Oral medications

Oral medications are a successful erectile dysfunction treatment for many men. They include:

  • Sildenafil (Viagra)
  • Tadalafil (Adcirca, Cialis)
  • Vardenafil (Levitra, Staxyn)
  • Avanafil (Stendra)

All four medications enhance the effects of nitric oxide — a natural chemical your body produces that relaxes muscles in the penis. This increases blood flow and allows you to get an erection in response to sexual stimulation.

Taking one of these tablets will not automatically produce an erection. Sexual stimulation is needed first to cause the release of nitric oxide from your penile nerves. These medications amplify that signal, allowing normal penile function in some people. Oral erectile dysfunction medications are not aphrodisiacs, will not cause excitement and are not needed in people who get normal erections.

The medications vary in dosage, how long they work and side effects. Possible side effects include flushing, nasal congestion, headache, visual changes, backache and stomach upset.

Your doctor will consider your particular situation to determine which medication might work best. These medications might not treat your erectile dysfunction immediately. You might need to work with your doctor to find the right medication and dosage for you.

Before taking any medication for erectile dysfunction, including over-the-counter supplements and herbal remedies, get your doctor’s OK. Medications for erectile dysfunction do not work in everyone and might be less effective in certain conditions, such as after prostate surgery or if you have diabetes. Some medications might also be dangerous if you:

  • Take nitrate drugs — commonly prescribed for chest pain (angina) — such as nitroglycerin (Nitro-Dur, Nitrostat, others), isosorbide mononitrate (Monoket) and isosorbide dinitrate (Dilatrate-SR, Isordil, Bidil)
  • Have heart disease or heart failure
  • Have very low blood pressure (hypotension)

Other medications

Other medications for erectile dysfunction include:

  • Alprostadil self-injection. With this method, you use a fine needle to inject alprostadil (Caverject, Edex) into the base or side of your penis. In some cases, medications generally used for other conditions are used for penile injections on their own or in combination. Examples include alprostadil and phentolamine. Often these combination medications are known as bimix (if two medications are included) or trimix (if three are included).Each injection is dosed to create an erection lasting no longer than an hour. Because the needle used is very fine, pain from the injection site is usually minor.Side effects can include mild bleeding from the injection, prolonged erection (priapism) and, rarely, formation of fibrous tissue at the injection site.
  • Alprostadil urethral suppository. Alprostadil (Muse) intraurethral therapy involves placing a tiny alprostadil suppository inside your penis in the penile urethra. You use a special applicator to insert the suppository into your penile urethra.The erection usually starts within 10 minutes and, when effective, lasts between 30 and 60 minutes. Side effects can include a burning feeling in the penis, minor bleeding in the urethra and formation of fibrous tissue inside your penis.
  • Testosterone replacement. Some people have erectile dysfunction that might be complicated by low levels of the hormone testosterone. In this case, testosterone replacement therapy might be recommended as the first step or given in combination with other therapies.
A battery-powered penis pump
Penis pumps, surgery and implants

Penis pumps, surgery and implants

If medications aren’t effective or appropriate in your case, your doctor might recommend a different treatment. Other treatments include:

  • Penis pumps. A penis pump (vacuum erection device) is a hollow tube with a hand-powered or battery-powered pump. The tube is placed over your penis, and then the pump is used to suck out the air inside the tube. This creates a vacuum that pulls blood into your penis.Once you get an erection, you slip a tension ring around the base of your penis to hold in the blood and keep it firm. You then remove the vacuum device.The erection typically lasts long enough for a couple to have sex. You remove the tension ring after intercourse. Bruising of the penis is a possible side effect, and ejaculation will be restricted by the band. Your penis might feel cold to the touch.If a penis pump is a good treatment choice for you, your doctor might recommend or prescribe a specific model. That way, you can be sure it suits your needs and that it’s made by a reputable manufacturer.
  • Penile implants. This treatment involves surgically placing devices into both sides of the penis. These implants consist of either inflatable or malleable (bendable) rods. Inflatable devices allow you to control when and how long you have an erection. The malleable rods keep your penis firm but bendable.Penile implants are usually not recommended until other methods have been tried first. Implants have a high degree of satisfaction among those who have tried and failed more-conservative therapies. As with any surgery, there’s a risk of complications, such as infection. Penile implant surgery is not recommended if you currently have a urinary tract infection.