Sildenafil citrate is an oral medication prescribed by doctors to treat erectile dysfunction (ED) in men. Sildenafil is the active ingredient found in Viagra®, its branded version manufactured by pharmaceutical giant Pfizer.
Sildenafil helps relax muscles and increase blood flow to induce erections in men struggling with the symptoms of impotence as a vasodilator.
Sildenafil may also be prescribed to treat pulmonary arterial hypertension (PAH), a condition wherein the blood vessels in the lungs are blocked, damaged, or narrowed, leading to an increase in blood pressure within the lung’s arteries. Pfizer markets sildenafil to treat PAH under the brand name Revatio® to distinguish it from Viagra®.
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What is sildenafil? How does it treat impotence?
Erectile dysfunction, also known as impotence, means that you can’t produce and keep a proper erection.
The most common cause of ED is a narrowing or blockage in the arteries that circulate blood into and around the penis.
How does sildenafil work?
Sildenafil helps men suffering from ED symptoms by boosting blood circulation in the penis by preventing the action of phosphodiesterase type-5, an enzyme in the body responsible for increasing cyclic guanosine monophosphate (cGMP).
PDE5 regulates cGMP, signaling pathways in physiological processes such as smooth muscle contraction and relaxation.
PDE5 inhibitors are a category of medicines used to treat ED. Sildenafil (Viagra®), tadalafil (Cialis®), vardenafil (Levitra®), and avanafil (Stendra) belong to this group of medicines that allow cGMP to accumulate in the corpus cavernosum of the penile tissue, allowing blood vessels to relax and increase blood flow by relaxing the smooth muscles within it – therefore causing an erection after sexual stimulation.
On the other hand, sildenafil works in pulmonary arterial hypertension (PAH) patients by decreasing blood pressure in the lungs by widening its blood vessels and relaxing its related muscles. This leads to a reduction in blood pressure since there is less resistance to the blood flow.
How soon does sildenafil take effect?
Around 25% to 63% of orally-administered sildenafil reaches the bloodstream.
When taken on an empty stomach, sildenafil takes around 30 to 120 minutes to attain maximum concentration within the body. However, taking sildenafil with a high-calorie, high-fat meal may increase this time to several hours.
Approximately 80% of sildenafil is expelled through feces and the remainder through urine.
In general, the onset of action for sildenafil is around 30 to 120 minutes after oral administration, while its action may last as long as 8-12 hours. Thus far, no reports regarding habit-forming tendencies have been reported by individuals taking sildenafil.
Is sildenafil effective?
Two-thirds of men taking sildenafil for erectile dysfunction have reported improved erection quality and satisfaction after taking sildenafil, upholding its success as a highly effective treatment for ED.
Studies and feedback from patients support the claim of sildenafil citrate as an effective ED treatment. According to studies conducted on its long-term efficacy, over 95% of participants reported increased sexual performance and their ability to engage in sexual activity.
However, it must be noted that sildenafil citrate won’t cause erections taken on its own. It also must be noted that taking sildenafil will not cure erectile dysfunction, nor will it enhance your ability to feel aroused. Rather, sildenafil allows you to obtain and keep a satisfyingly hard erection when you are in a state of sexual arousal.
When and how should sildenafil be taken?
Generic sildenafil for ED, like its branded counterpart Viagra®, comes in tablet form in varying strengths – 25 mg, 100 mg, and 100 mg. Never take more than one tablet unless explicitly prescribed by your doctor to adjust your dose.
Most men will begin feeling its effects around 30 minutes to an hour. Therefore it’s best to take sildenafil approximately 45 minutes to an hour before engaging in sexual activity.
To reiterate, erections produced by orally-administered sildenafil don’t happen spontaneously; instead, they require sexual stimulation.
What drugs should not be taken with sildenafil?
Alpha-blockers are a class of blood pressure medications that reduce blood pressure by preventing a hormone responsible for preventing veins and arterial walls from tightening up, therefore opening up and relaxing blood vessels. If you are taking alpha-blockers such as tamsulosin or doxazosin, you will need to wait at least 6 hours between taking them and taking sildenafil.
You may be unsuitable for sildenafil if you take nitrates such as isosorbide mononitrate used to treat angina (chest pain).
Consult your primary healthcare provider and let them know about any prescriptions, OTC medicines, and recreational drugs you are taking so that they can prescribe you sildenafil (or another alternative) safely.
What are the side effects of sildenafil?
Sildenafil’s most common side effects include the following:
- Headaches
- Light-headedness or dizziness
- Blurred vision or distortions in perceiving colors
- Flushing
- Nasal congestion
- Nausea
- Gastrointestinal discomfort
Rarer side effects might include allergic reactions or priapism, a painful condition resulting in an erection lasting more than 4 hours. Both side effects require immediate medical attention. Consult your doctor and make sure you’ve read the information leaflet to be fully aware of such side effects and whether they might affect you.
How are the side effects of sildenafil monitored?
No blood work for side effects pertaining to sildenafil is required.
Your primary healthcare provider may recommend that you monitor your blood pressure regularly, especially during your first few days on sildenafil or after an adjustment in dosage strength. However, regular blood pressure monitoring is generally unnecessary for most individuals.
However, if you experience any of the side effects mentioned earlier, you should let your doctor know immediately.
Can I drink alcohol while taking Sildenafil?
Drinking a bottle of beer or a glass of wine isn’t likely to affect or delay sildenafil’s effects. However, consuming any more alcohol than this may make it harder for you to obtain an erection. If you want to get the best results from sildenafil, it’s advisable not to overindulge in alcohol as it is known as an erection killer.
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Conclusion
Sildenafil works well for patients with ED, and it helps you keep an erection long and firm enough to enjoy satisfying sex. If you have any other questions or concerns about sildenafil and its effects, consult your doctor or pharmacist.
