Viagra: Uses, Dosage, Side Effects, & More

What Is Viagra?

Viagra (sildenafil) belongs to the class of drugs called phosphodiesterase (PDE) inhibitors. Viagra is FDA-approved as a medication to treat erectile dysfunction (ED) by enhancing blood flow to the penis during sexual stimulation. The increase in blood flow aids in achieving and sustaining an erection. When a medication is FDA-approved, like Viagra, it means that the U.S. Food and Drug Administration has meticulously evaluated and verified its safety and effectiveness for treating ED in men.

Sildenafil, the generic form of Viagra, functions the same way as the brand-name medication and is available as a more cost-effective alternative.^{1, 2} Viagra can also be used off-label to treat pulmonary hypertension and certain heart diseases.^{2, 3} An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.

Does Viagra Work to Treat ED?

Viagra is designed to help men with erectile dysfunction (ED) regain their ability to have satisfying sexual experiences. It does this by targeting a specific enzyme called phosphodiesterase type 5 (PDE5). During sexual arousal, the body naturally produces a substance called nitric oxide, which helps relax the blood vessels in the penis, allowing more blood to flow in. This increased blood flow allows an erection to occur. Viagra doesn’t increase sexual desire, but it does help your body respond.^{2, 3}

Viagra for Raynaud’s Disease

Viagra may be used off-label to treat Raynaud’s disease, a condition where fingers and toes become extremely cold and numb due to narrowed blood vessels. An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.

While Viagra is mainly known for helping with erectile dysfunction, it can also help relax blood vessels in other parts of the body, including the fingers and toes. This improved blood flow can alleviate the symptoms of Raynaud’s disease by reducing the frequency and severity of attacks, helping patients feel more comfortable in cold conditions.^{2, 4}

Can Women Take Viagra?

While Viagra (sildenafil) is primarily used to treat erectile dysfunction in men, doctors may also prescribe Viagra for women as an off-label treatment for certain medical conditions. Sildenafil can be used to improve blood flow in the uterus and help with conditions like unexplained infertility or Raynaud’s disease (which causes finger and toe numbness). It is crucial for you to consult your healthcare provider for a thorough evaluation and to discuss whether sildenafil could be an appropriate treatment for your specific medical concerns. Always follow your doctor’s guidance when considering any medication.^{1, 2, 5}

Is There a “Female Viagra”?

Viagra (sildenafil) is FDA-approved to treat erectile dysfunction in men by increasing blood flow to the penis. While some may wonder if it works similarly for women, it’s essential to understand that Viagra is not approved by the FDA for treating sexual issues in women. Women’s sexual concerns can be different from men’s, often related to a lower interest in sex, known as low libido.

For women experiencing such issues, there are alternatives like Addyi (flibanserin), which is FDA-approved to address low libido in premenopausal women. It’s important to consult with a healthcare provider to determine the most appropriate treatment for individual needs and to understand the potential side effects and risks associated with these medications.^{1, 5}

How Long Viagra Lasts

Viagra typically lasts for 4 hours after you take it. This means that during this time frame, you may find it easier to get and maintain an erection when sexually aroused. However, it’s important to remember that an erection lasting longer than 4 hours, a condition called priapism, can be dangerous. If priapism happens, seek immediate medical attention. Always take Viagra as prescribed by your healthcare provider, and remember that it does not increase your sexual desire but helps your body respond when you are in the mood for intimacy.^{1, 3}

How Long Does Viagra Take to Work?

Viagra typically takes about 30 minutes to 1 hour to start working after you take it. It’s best to take it before any planned sexual activity, as it needs some time to get into your system and start improving blood flow to the penis. However, it can work as quickly as 15 minutes for some people. Keep in mind that it may work more slowly if you’ve had a large meal with high-fat content, so taking it on an empty stomach might make it work faster. Always follow your healthcare provider’s instructions for the best results.^{1, 3}

What Can I Do to Make Viagra Work Faster?

To help Viagra work faster, take it on an empty stomach. Avoid consuming alcohol and heavy high-fat meals before taking Viagra, as these can delay its effects by slowing absorption in the body. Being sexually aroused is essential for Viagra to work, foreplay may be necessary to increase your arousal. Viagra usually takes about 30 minutes to 1 hour to start working, so be sure to plan accordingly. Always follow your healthcare provider’s recommendations for the safest and most effective use of Viagra.^{1, 3, 5}

Viagra Alternatives

Alternatives to Viagra for treating erectile dysfunction (ED) include Cialis (tadalafil) and Levitra (vardenafil). Cialis and Levitra which work similarly to Viagra but may have different durations of action. An additional option is a vacuum erection device, which is a non-medication approach to achieving an erection. Lifestyle changes such as regular exercise, a healthy diet, and managing stress may also help with ED. It is important to consult your healthcare provider to discuss the best treatment option for your specific needs.^{2, 3, 4}

Cialis Vs Viagra

Cialis (tadalafil) and Viagra (sildenafil) are both medications used to treat erectile dysfunction (ED). They work in similar ways by increasing blood flow within the penis, helping you achieve and maintain an erection when sexually aroused. The key difference between Cialis vs Viagra is the duration of their effects; Cialis can work for up to 36 hours, while Viagra typically lasts for around 4 hours. This longer duration has earned Cialis the nickname “the weekend pill.” The choice between them often depends on individual preferences and the frequency of sexual activity. Always consult your doctor or pharmacist to determine the best option for you.^{2, 3, 4}

Viagra Vs Sildenafil

Viagra is the brand name for sildenafil. Both medications are used to treat erectile dysfunction (ED) by increasing blood flow to the penis. The main difference is the higher price of Viagra, with generic sildenafil typically being more affordable. Some individuals prefer brand-name Viagra, while others opt for generic sildenafil due to cost savings. It’s important to consult your healthcare provider to determine which option is best for you based on your specific needs and circumstances.^{1, 3, 4}

Levitra Vs Viagra

Levitra (vardenafil) and Viagra (sildenafil) are both medications used to treat erectile dysfunction (ED). They work in a similar way by increasing blood flow to the penis, helping you achieve and maintain an erection when sexually aroused. One key difference is that Levitra may work a little faster for some individuals compared to Viagra. However, individual responses can vary, so it’s essential to consult your healthcare provider to determine which medication is the best fit for your specific needs.^{2, 3, 4}

How Effective is Viagra?

Viagra (sildenafil) is highly effective in treating erectile dysfunction (ED) proven by many clinical research studies. Men who used Viagra in these studies experienced significant improvements in their ability to achieve and maintain erections, enabling sexual activity.

Research findings reveal that Viagra led to improved erections in a substantial number of men, with rates ranging from 43% to 83%. The effectiveness of Viagra varied depending on factors like the underlying cause of ED and the dosage taken. These findings underscore the effectiveness of Viagra in helping men regain their sexual confidence and satisfaction, making it a reliable option for many experiencing ED. However, it is essential to consult with a healthcare provider to determine the most appropriate treatment for your specific situation.^{1, 2, 3, 4}

Viagra Warnings & Precautions

Viagra (sildenafil) is an effective medication for treating erectile dysfunction (ED). However, it comes with some important warnings and precautions that patients need to be aware of. It’s essential to consider your heart health before using Viagra, especially if you have preexisting heart conditions. Consult your doctor or pharmacist to determine if Viagra is safe for you, as sexual activity can pose a potential heart risk. While rare, a prolonged erection lasting more than 4 hours, known as priapism, can occur with Viagra use. Seek immediate medical attention if this happens, as it can lead to penile tissue damage.

In rare cases, Viagra use has been associated with sudden hearing loss, and there have been reports of bleeding events in patients who have taken the medication. It is crucial to monitor for any unusual symptoms and promptly consult your doctor or pharmacist if you experience sudden vision or hearing changes or any signs of bleeding. Always follow your healthcare provider’s guidance and discuss any concerns or potential risks before using Viagra to ensure your safety and the best treatment outcomes. Viagra does not protect against sexually transmitted diseases (STDs), so practicing safe sex and using protection is essential to prevent STDs, including HIV/AIDS.¹

Avoid taking Viagra if you:^{1, 2, 4}

• Are diagnosed with a heart condition: If you have a cardiovascular condition, it’s best to avoid taking Viagra because it can impact your heart and may not be safe for individuals with heart problems. If you have concerns about using Viagra with a heart condition, consult your doctor or pharmacist for personalized guidance.
• Have allergic reactions: If you’ve experienced allergic reactions to Viagra or its components in the past, it’s important to avoid using it again. Allergic reactions can be severe and may include symptoms like rash, itching, swelling, severe dizziness, or trouble breathing.
• Have a history of liver problems: If you have a history of liver problems, it is important to avoid taking Viagra because your liver plays a role in breaking down the medication in the body, and Viagra may not be safe for individuals with liver issues. Those with a history of liver problems should consult their doctor or pharmacist for alternative treatments or to assess the safety of using Viagra.
• Are breastfeeding or pregnant: Pregnant women should avoid using Viagra because it has been shown to cross the placenta and may have adverse effects on the unborn fetus. Viagra is not recommended for use during pregnancy outside of controlled clinical research studies due to potential risks. If you are breastfeeding, be aware that Viagra can be present in breast milk, so it’s important to discuss its use with your healthcare provider to ensure the safety of both you and your baby.
• Have difficulty distinguishing colors: Viagra may lead to difficulties in distinguishing colors, especially at higher doses. If you have a condition like retinitis pigmentosa or genetic disorders in your eyesight, it is essential to use Viagra with caution since there is limited safety information available for individuals with these eye conditions. Always discuss any concerns with your healthcare provider before using Viagra.
• Are an older adult (age 60+): If you are an older adult, it’s important to be cautious when considering Viagra because older adults often have other medical conditions or take medications that may not mix well with Viagra. Your doctor or pharmacist should carefully assess your past medical history and any medications you’re taking before prescribing or dispensing Viagra. Your prescriber may adjust the dose based on your kidney and liver function to ensure your safety and the effectiveness of the medication. Always consult with your doctor or pharmacist for personalized guidance.
• Have a bleeding disorder: Viagra has been linked to some reports of bleeding events, but it is not clear if the medication directly causes bleeding events. In some research, Viagra seemed to alter the effect of certain substances in the body that affect blood clotting.

Side Effects of Viagra

Side effects of Viagra that can persist as long as you’re on the medication include headaches, digestive discomfort like indigestion or diarrhea, muscle aches, and potential vision changes, such as seeing things with a bluish tint.

Temporary side effects of Viagra are often experienced while your body adapts to the medication. These can include facial flushing, nasal congestion, and occasional dizziness. It’s important to note that not everyone will encounter these side effects, and they tend to improve with time or dose adjustments. If you have concerns or severe symptoms, consult your doctor or pharmacist for advice and potential alternatives.^{1, 2, 3}

Common Side Effects of Viagra

Common side effects of Viagra can include flushing, diarrhea, indigestion, headaches, muscle aches, vision changes, and nosebleeds. These side effects are often mild and don’t require medical attention. If you find these side effects bothersome or if they persist or worsen, it’s a good idea to talk to your doctor or pharmacist. If you experience severe side effects like sudden vision changes or prolonged erections, seek immediate medical care. Your doctor or pharmacist can help determine if Viagra is the right choice for you and address any concerns you may have about side effects.^{1, 2, 3}

Common side effects of Viagra include:^{1, 2}

• Flushing
• Diarrhea
• Indigestion
• Headache
• Back pain
• Limb pain
• Myalgia
• Vision changes
• Nosebleeds

*All medications, including Viagra, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor or pharmacist about any questions you have and to understand the potential side effects and benefits of any medication.

Serious Side Effects of Viagra

While Viagra can be effective for many, it’s important to be aware of serious side effects that require immediate medical attention. These rare side effects include an erection that persists for more than 4 hours, sudden vision loss in one or both eyes or changes in hearing may also occur. If you experience any of these symptoms while taking Viagra, stop using the medication and seek prompt medical care to address these serious concerns. Your doctor or pharmacist can provide guidance and appropriate treatment.^{1, 2, 3}

Serious side effects of Viagra include:*^{1, 2, 3}

• Priapism (erection lasting more than 4 hours)
• Vision Loss
• Hearing changes
• Hearing Loss
• Tinnitus (ringing in the ears)

Priapism

If you find yourself with an erection that won’t go away after 4 hours after using Viagra, it’s crucial to seek immediate medical assistance. Without prompt treatment, this condition, known as priapism, can lead to permanent damage to your penis.

Sudden Vision Loss in One or Both Eyes

If you experience a sudden loss of vision in one or both eyes while using Viagra, it could indicate a severe eye issue known as non-arteritic anterior ischemic optic neuropathy (NAION). It is essential to stop taking Viagra immediately and reach out to your healthcare provider right away for assistance.

Sudden Hearing Decrease or Hearing Loss

If you notice a sudden decrease in hearing or experience hearing loss while using Viagra, along with symptoms like ringing in your ears (tinnitus) or dizziness, it is crucial to stop taking Viagra immediately. Reach out to your healthcare provider promptly for evaluation and appropriate care.

Allergic Reaction

If you experience signs of an allergic reaction to Viagra, such as rash, hives, itching, or swelling of the face, lips, tongue, or throat, along with symptoms like difficulty breathing or tightness in the chest, seek immediate medical attention. These reactions can be severe and may include skin problems like redness, swelling, or peeling. Seek help from your healthcare provider immediately.

Cardiovascular Problems

In some cases, Viagra can lead to serious heart issues, particularly in those with pre-existing heart conditions. Symptoms include chest pain, heart attacks, heart failure, or strokes. If you have a history of heart disease and experience any of these symptoms while taking Viagra, it’s crucial to seek immediate medical attention.

*All medications, including Viagra, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor or pharmacist about any questions you have and to understand the potential side effects and benefits of any medication.

How to Relieve Viagra Side Effects

You may be able to manage your mild Viagra side effects. To combat flushing, try cooling down by opening a window, using a fan, or having a cold drink. Resting and lying down may also help control flushing. If indigestion occurs, taking Viagra with food may alleviate discomfort, though it may delay Viagra’s effects.

Over-the-counter antacids may provide relief from indigestion, and your pharmacist can recommend suitable options for you. For dizziness, lie down, rest, and rise slowly. In addition, stay hydrated with fluids to avoid dizziness. If you experience back or muscle pain, consider resting or a gentle massage, and consult your pharmacist about over-the-counter pain relievers.

If discontinuing Viagra, mild side effects like flushing, indigestion, dizziness, or muscle pain last for a few hours to a day as Viagra fully leaves your system. If symptoms persist or worsen, contact your doctor or pharmacist.^{1, 2}

When to Call Your Doctor About Viagra Side Effects

If you experience persistent or severe side effects while taking Viagra, it’s essential to contact your doctor or pharmacist promptly. While many Viagra side effects are mild and temporary, persistent or severe symptoms could indicate an underlying issue that requires attention.¹

Viagra Dosages for FDA-Approved Treatment

Viagra is FDA-approved for the treatment of erectile dysfunction (ED). The typical starting Viagra dosage for ED is 50 mg, taken 1 hour before sexual activity, with the option to take it between 30 minutes to 4 hours before. You should not take more than one dose per day.

Your prescriber may adjust your dosage depending on your response and tolerance. Some individuals may need a maximum of 100 mg, while others may require a lower 25 mg dose if they experience side effects or have specific health considerations. Viagra can be taken with or without food, though it’s essential to consider potential interactions with other medications. It’s crucial to avoid Viagra if you use nitrate medications (e.g. isosorbide, nitroglycerin) or certain medications like alpha-blockers (e.g. tamsulosin), as combining them can be unsafe.

For special populations, such as those over 65 or those with liver issues, or severe kidney impairment, a 25 mg starting dose may be recommended due to potential higher sildenafil levels in the bloodstream. Your prescriber will tailor your Viagra dosage based on your unique circumstances to ensure both safety and effectiveness.¹

Viagra Forms & Strengths

Viagra is available in different strengths, offering flexibility to meet individual needs. Viagra comes as a blue, film-coated tablet to help prevent stomach side effects. The choice of the most appropriate strength depends on several factors. Prescribers consider a person’s overall health, the severity of their erectile dysfunction, and how well they respond to the medication.

Viagra tablets are not extended-release or delayed-release, and they usually take effect within 30 minutes to an hour after taking them, with the effects lasting for about four hours.^{1, 3, 4}

Viagra is available in the following forms and strengths:¹

• 25 milligrams (mg) tablet
• 50 milligrams (mg) tablet
• 100 milligrams (mg) tablet

How Should I Take Viagra?

It is best to take Viagra 1 hour before planning sexual activity. You may take Viagra anywhere from 30 minutes to 4 hours before intimacy. Do not take Viagra more than once per day. Viagra can be taken with or without food. Taking Viagra with larger meals or fatty meals may delay it’s effects. It is crucial to follow your healthcare provider’s instructions carefully to ensure that you get the most benefit from the medication and minimize any potential risks or side effects.^{3, 4}

What Happens If I Miss a Dose of Viagra?

If you miss a dose of Viagra, do not be concerned. Viagra is taken as needed, primarily before sexual activity, so there is no daily dose regimen to follow, like other medications. You should take it when you plan to be sexually active.¹

Can You Overdose on Viagra?

Yes, you can overdose on Viagra. Overdosing can lead to an increased risk of severe side effects. Signs and symptoms of a Viagra overdose may include extreme dizziness, fainting, chest pain, irregular heartbeat, and even a painful, prolonged erection lasting for more than four hours (priapism). If you or someone you know suspects an overdose, it’s crucial to seek immediate medical attention by contacting your healthcare provider or going to the nearest emergency room. Always take Viagra exactly as your doctor has prescribed to avoid the risk of an overdose and ensure your safety while using this medication.^{1, 6}

What Should You Do If You Take Too Much Viagra?

If you believe you’ve taken too much Viagra, it’s vital to seek immediate medical help. Call 911 or go to the nearest emergency room right away. An overdose can lead to serious health complications. It’s essential to provide as much information as possible about the amount of Viagra taken and any symptoms experienced.^{1, 6}

What to Avoid When Taking Viagra

When taking Viagra, it’s important to avoid certain medications, substances, and herbs that can interact with it and potentially cause harmful effects. You should avoid nitrates in any form, such as nitroglycerin or isosorbide, as combining them with Viagra can lead to a dangerous drop in blood pressure. Additionally, recreational drugs like poppers (amyl nitrite) may interact adversely with Viagra.

It’s crucial to inform your healthcare provider about all the medications, supplements, and herbs you take to ensure they don’t interact negatively with Viagra. Always follow your doctor and pharmacist’s recommendations to minimize the risk of harmful interactions and ensure your safety while using Viagra.^{2, 3, 4}

6 substances you should avoid while taking Viagra include:

Viagra & Grapefruit

When Viagra is consumed along with high amounts of grapefruit juice, it can lead to potentially harmful outcomes. Grapefruit juice can affect the liver, and drinking a significant amount of grapefruit juice may increase the levels of Viagra in your body. This can result in more intense side effects like low blood pressure and headaches.⁷

Viagra & Alcohol

Alcohol can contribute to or worsen erectile dysfunction (ED), which contradicts the intended purpose of Viagra. Both alcohol and Viagra widen blood vessels in the body, which increases the risk of low blood pressure when used together. Lastly, alcohol may also intensify other side effects associated with sildenafil, such as headaches and facial flushing. It is recommended to avoid alcohol when taking sildenafil.¹

Viagra & Nitrates

Combining nitrates, which are medications used to treat heart conditions like chest pain (angina), with Viagra can lead to a dangerous outcome. Nitrates, such as nitroglycerin and isosorbide, work by widening the blood vessels throughout the body. While this helps improve blood flow to the heart, it can also lower blood pressure. When nitrates and Viagra are taken together, they can cause a significant drop in blood pressure.^{1, 2}

Viagra & Alpha-blockers

Combining alpha-blockers with Viagra can potentially lead to low blood pressure. Alpha-blockers are medications used to treat conditions such as benign prostatic hyperplasia (BPH or enlarged prostate) and high blood pressure. Examples of alpha-blockers include tamsulosin (Flomax), alfuzosin (Uroxatral), and doxazosin (Cardura). These medications, like both sildenafil (the active ingredient in Viagra) and nitrates, work by relaxing blood vessels. It’s crucial to inform your doctor or pharmacist if you experience signs of low blood pressure, such as dizziness or lightheadedness.^{1, 3, 4}

Viagra & Blood Pressure Medications

If you are taking blood pressure medications with Viagra, your healthcare provider may recommend more frequent blood pressure checks to monitor your levels closely. If you notice that your blood pressure becomes too low, it is essential to promptly communicate with your provider, as they may need to adjust your Viagra dose to ensure your safety and well-being.^{1, 3}

Viagra & High-fat Meals

You may take Viagra with or without food. However, it is important to be aware that consuming a heavy or high-fat meal just before taking Viagra can affect its effectiveness in achieving and maintaining an erection. When Viagra is taken with a substantial meal, especially one high in fat content, the absorption can be delayed by approximately one hour.

To optimize the medication’s effectiveness, it’s recommended to take Viagra on an empty stomach or after a lighter meal. This allows your body time to digest the food, facilitating quicker and more efficient absorption of the medication into your bloodstream, which can enhance its effectiveness in supporting your sexual performance.^{3, 4}

Questions to Ask Your Healthcare Provider About Viagra

Questions to ask your care team about Viagra include:^{1, 4, 5}

• Can Viagra cause any side effects in my partner?
• Will the 100-mg dose of Viagra cause more side effects than the 50-mg dose?
• Is it safe to take Viagra if I have diabetes?
• Can taking Viagra cause migraine episodes?
• Can Viagra cause a heart attack in people who don’t have heart disease?
• How can I get rid of a stuffy nose after taking Viagra?
• How do I know if my ED is psychological?
• How effective is Viagra for ED?
• What happens when Viagra doesn’t work?
• Will taking Viagra affect my fertility?
• Is it safe if I use Viagra with other ED medications?
• Is Viagra addictive?

In My Experience

In my experience, discussing the use of Viagra with your doctor or pharmacist is extremely important due to potential interactions and side effects. While Viagra effectively treats erectile dysfunction, it’s not without considerations. Understanding factors affecting its effectiveness, such as food intake, other medications, and medical conditions, is essential. Seeking treatment and support for erectile dysfunction is a positive step toward improving one’s quality of life and well-being.

The outlook for patients facing this issue is positive, given the range of available treatments, including Viagra. Individual responses to medication can vary, requiring some trial and error to find the most suitable treatment. I advise patients to engage in open discussions with their prescriber and pharmacist, addressing concerns, current medications, and overall health for the safe and effective use of Viagra. Lifestyle factors like diet and alcohol consumption can also influence outcomes, making healthy choices crucial for success.