Sildenafil is used to treat male sexual function problems (impotence or erectile dysfunction-ED). Sildenafil works by increasing blood flow to the penis to help a man get and keep an erection. ED drug does not protect against sexually transmitted diseases (such as HIV, hepatitis B, gonorrhea, syphilis).
What Are the Recommended Dosages for Sildenafil Medication?
This medication is available in convenient tablets, jelly and liquid suspension format in 25mg, 50mg, 75mg, 100mg, 120mg, 130mg, 150mg, 200mg dosages for men. Sildenafil Cream is available for women. Sildenafil Oral Spray, distributed and marketed in Spain on behalf of Farmalider by Laboratorios Rubio under the trade name, “Bandol”, is prescribed by Spanish physicians to treat erectile dysfunction as an alternative to Viagra and Cialis tablets.
How Should Sildenafil Be Used to Treat Erectile Dysfunction (ED)?
Read the Patient Information Leaflet provided by your pharmacist before you start taking Sildenafil and each time you get a refill.
To treat erectile dysfunction-ED, take one pill of Sildenafil an hour before you plan to have intimate encounters with a glass of water. Sildenafil ED Medication takes about 30 minutes to start working in your body. A high-fat meal delays how quickly the drug begins to work.
What Is the Mechanism of Action of Sildenafil?
Sildenafil is an oral therapy for erectile dysfunction.
The physiological mechanism responsible for the erection of the penis involves the release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. Nitric oxide then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate (cGMP), producing smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood.
Sildenafil is a potent and selective inhibitor of cGMP specific phosphodiesterase type 5 (PDE5) in the corpus cavernosum, where PDE5 is responsible for degradation of cGMP. Sildenafil has a peripheral site of action on erections. Sildenafil has no direct relaxant effect on isolated human corpus cavernosum, but potently enhances the relaxant effect of NO on this tissue. Inhibition of PDE5 by Sildenafil results in increased corpus cavernosum levels of cGMP When the NO/cGMP pathway is activated, as occurs with sexual stimulation. Sildenafil blocks the action of an enzyme known as cGMP-specific phosphodiesterase type-5 (PDE-5). Sexual stimulation is required in order for Sildenafil to produce its intended beneficial pharmacological effects.
Sildenafil, therefore, increases cGMP within pulmonary vascular smooth muscle cells, resulting in relaxation.
Sildenafil causes a modest reduction in blood pressure, even when taken with other blood pressure-lowering drugs, providing reassurance on safety when taken as a single dose for erectile dysfunction
Is Sildenafil a Better Choice Compared to Viagra for ED Treatment?
Sildenafil is as good as Viagra. The brand name Viagra and its generic counterpart Sildenafil are similar medications invented and marketed by Pfizer. ED medications produce noticeable positive effects on treating erectile dysfunction and improvements in your erections and sexual performance.
What Are the Potential Side Effects of Sildenafil Medication?
Tell your doctor or pharmacist, if any of the side effects listed below occur.
- Dizziness
- Headache
- Flushing
- Stomach upset
- Vision changes such as increased sensitivity to light, blurred vision
Get up slowly when rising from a sitting or lying position, to reduce the risk of dizziness and lightheadedness.
Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Sexual activity puts extra strain on your heart, especially if you have heart problems. Stop and get medical help, if you have heart problems and experience any of these serious side effects while having sex
Rarely, sudden decreased vision, including permanent blindness, in one or both eyes (NATIONN) occur. You have a slightly greater chance of developing NAION if you have heart disease, diabetes, high cholesterol, certain other eye problems (“crowded disk”), high blood pressure, if you are over 50, or if you smoke.
How Should Sildenafil Citrate Tablets Be Stored Properly?
Properly storing your medications helps keep your drugs safe, effective, and away from others. Follow the tips above for all your medications, including prescription and over-the-counter products.
- Do store your medications in a cool, dry place, away from direct heat or light.
- Do keep all your medications up high, out of the reach of children and pets.
- Store medicines in their original containers with the safety cap on and secured.
- Do keep your medications separate from other household members’ prescriptions.
- Don’t store your medicines in the refrigerator unless indicated.
- Don’t keep medications past their expiration date.
- Don’t keep unused medications after your treatment has ended.
What are the best sildenafil ED medications?
28 best sildenafil medications with manufacturer and prices are listed in the table below.
| # | Pills | Manufacturer | Type | Price |
|---|---|---|---|---|
| 1 | Aurogra 100mg | Aurochem laboratories (i) pvt. ltd. | Tablet | $1.34 |
| 2 | Abhigra 100mg | Abhiflax Pharma Chem Pvt. Ltd. | Tablet | $3.66 |
| 3 | Assurans 20mg | Cipla Ltd. | Tablet | $2.35 |
| 4 | Caverta 100mg | Ranbaxy Laboratories Ltd. | Tablet | $5.07 |
| 5 | Cenforce 100mg | Centurion Laboratories Pvt Ltd. | Tablet | $2.83 |
| 6 | Eriacta 100mg | Ranbaxy Laboratories Ltd. | Tablet | $3.07 |
| 7 | Eunice 100mg | Sandoz India Pvt. Ltd. | Tablet | $4.37 |
| 8 | Filagra oral jelly flavored 100mg | Fortune Healthcare Pvt. Ltd | Sachets | $3.22 |
| 9 | Fildena 100mg | Fortune Healthcare Pvt. Ltd | Tablet | $1.34 |
| 10 | Genegra (Viagra Strips) | Aavishkar Oral Strips Pvt Ltd. | Strips | $4.20 |
| 11 | Hardon oral jelly 100mg | Aurochem Labs | Sachets | $4.48 |
| 12 | Hiforce ODS (Sildenafil Oral Strips) | Healing Pharma India Pvt Ltd. | Strips | $4.90 |
| 13 | Intagra 100 mg | Intas Pharmaceuticals ltd | Tablet | $3.5 |
| 14 | Kamagra | Ajanta Pharma Limited | Tablet | $2.14 |
| 15 | Manforce 100mg | Mankind Pharma ltd | Tablet | $8.25 |
| 16 | Nizagara 100mg | Combitic Global Caplet Pvt Ltd. | Tablet | $3.69 |
| 17 | Novosil 50mg | Euphoria Healthcare Pvt Ltd. | Strips | $6.19 |
| 18 | Penegra | Zydus Lifesciences Ltd | Tablet | $5.07 |
| 19 | P-force 100mg | Euphoria Healthcare Pvt Ltd. | Tablet | $1.33 |
| 20 | Red Viagra | Tablet | ||
| 21 | Silagra 100mg | Cipla Ltd. | Tablet | $1.51 |
| 22 | Sildamax 100mg | Agron Remedies Pvt. Ltd | Tablet | $2.50 |
| 23 | Sildigra 100mg | RSM Enterprises | Tablet | $1.36 |
| 24 | Suhagra 100mg | Cipla Ltd. | Tablet | $1.47 |
| 25 | Vega 100mg | Signature Pharmaceuticals Ltd. | Tablet | $8.77 |
| 26 | Vigora 100mg | German Remedies Ltd | Tablet | $3.32 |
| 27 | Viprogra 100mg | Vipro Lifescience pvt ltd | Tablet | $1.09 |
| 28 | Zenegra 100mg | Alkem Laboratories Ltd. | Tablet | $1.53 |
Viagra and Revatio (Sildenafil citrate 20mg) are just two common brand names containing Sildenafil. Other products use different active ingredients, such as Tadalafil, vardenafil, Avanafil or Udenafil.
What Medications Contain Sildenafil Citrate Tablets in Combination with Dapoxetine?
Pills containing Sildenafil Citrate Tablets and Dapoxetine are listed below.
- Extra Super Viagra
- Kamagra Super
- Super P-Force 160mg
What Medication Contains Sildenafil Citrate with Fluoxetine or Duloxetine?
Malegra pill contains Sildenafil Citrate with Fluoxetine/Duloxetine.
What pills contain Sildenafil Citrate Tablets with Tadalafil?
Pills containing Sildenafil Citrate Tablets and Tadalafil are listed below.
- Sildalis 120mg
- Tadasiva 120mg
What drug contains Sildenafil Citrate with Vardenafil?
Silvitra 120mg pill contains Sildenafil Citrate with Vardenafil.
Are There Any Known Interactions with Sildenafil Medication?
Inhibited effect with potent CYP3A4 inducers, such as carbamazepine, phenytoin, phenobarbital, St. John’s wort and rifampicin.
Action and toxicity potentiated by CYP3A4 inhibitors (such as ketoconazole, erythromycin, cimetidine, grapefruit juice).
Toxicity potentiated by HIV protease inhibitors.
Potentiates the hypotensive effects of nitrates, Riociguat.
Potentiating of toxicity with alpha blockers.
Co-administration of PDE5 inhibitors, including Sildenafil, with guanylate cyclase stimulators, such as Riociguat, is contraindicated.
The safety and efficacy of the association of Sildenafil with other PDE5 inhibitors, other treatments for pulmonary arterial hypertension (PAH) containing Sildenafil, or other treatments for erectile dysfunction have not been studied.
It has been observed that administration of a single dose of Sildenafil in patients with hypertension, under treatment with sacubitrile/valsartan (steady state), was associated with a significantly greater reduction in blood pressure compared to administration of sacubitrile/valsartan alone.
What Is Female Viagra, and How Does It Work?
Given the success of drugs to treat erectile dysfunction, such as Sildenafil (Viagra), Tadalafil (Cialis) and vardenafil (Levitra, Staxyn), Avanafil (Avana), Udenafil (Zudena) drug companies have sought a similar drug for women.
Sildenafil has even been tried as a treatment for sexual dysfunction in women. The U.S. Food and Drug Administration (FDA) hasn’t approved this use of Sildenafil.
There were no FDA-approved drugs for treating problems with sexual arousal or sexual desire in women for many years. 4 in 10 women report having sexual concerns. The FDA has now approved two medications.
The FDA has approved a daily pill called flibanserin (Addyi) — originally developed as an antidepressant — as a treatment for low sexual desire in premenopausal women.
Addyi boosts the sex drive in women with low sexual desire who find the experience distressing. Potentially serious side effects include low blood pressure, dizziness and fainting. Side effects occur if the drug is mixed with alcohol. The FDA recommends avoiding alcohol use if you take this drug. Experts recommend that you stop taking the drug if you don’t notice an improved sex drive after eight weeks.
The FDA has also approved an injectable medication, bremelanotide (Vyleesi), as a treatment for low sexual desire in premenopausal women. The medication injected in the stomach (abdomen) or thigh at least 45 minutes before anticipated sexual activity. Use Sildenafil not more than once a day or more than eight times a month. Potential side effects include nausea, headache, vomiting and reactions at the injection site.
Female Sildenafil pills are listed below.
- Cenforce FM 100mg
- Female Viagra 50mg
- Female Viagra 100mg
- Femalegra 100mg
- Ladygra 100mg
- Lady Era 100mg
- Lovegra 100mg
- Womenra 100mg
How Is Sildenafil Regulated and Available for Use?
The US FDA regulates Sildenafil as a prescription medicine.
Is Sildenafil Indicated for the Treatment of Erectile Dysfunction (ED)?
Sildenafil has two main indications in patients with erectile dysfunction and in those who suffer from pulmonary arterial hypertension, which is a rare disease, the aim is to dilate the pulmonary artery so that enough blood reaches it.
The main reason for the use of this drug, according to Javier Romero-Otero, director of the Department of Urology of HM Hospitales in Madrid and member of the Spanish Association of Urology, emphasizes that “every male patient who has erectile dysfunction must undergo a study to find out what the causes are”.
Javier Romero-Otero continues, “erectile dysfunction equals vascular disease, which means that the cardiovascular risk factors that cause myocardial infarction or stroke are the same as those that cause erectile dysfunction”.
Sexual problems are now considered “a window into men’s cardiovascular health, and it is important to diagnose it because often the biggest problem is a man has a generalized vascular disease that ends up triggering a heart attack, stroke or ischemia in the lower limbs (obstruction of one of the main arteries responsible for supplying blood to the legs)”.
Who Should Avoid Taking Sildenafil Medication?
Patients taking nitroglycerin or other nitrates for the treatment of myocardial infarction should not take Sildenafil. Taking nitroglycerin has serious medical conditions. “A person with severe heart failure cannot breathe, they choke,” stresses Romero-Otero. “It is common sense for these patients not to take Sildenafil applies to those with severe renal, hepatic or respiratory insufficiency, who are also unable to have an active sex life.
There are other isolated contraindications, such as certain patients with retinitis pigmentosa or uncontrolled hypertension, but the expert states that “these are very specific cases”.
What Are the Recommendations for Taking Sildenafil, and When Should It Be Administered?
Take Sildenafil orally at least 45 minutes before sexual intercourse and, considering that its effects last up to 6 hours. Other drugs of the same family favor erection up to 24 hours after ingestion.
Romero-Otero points out that stimulus is required for an erection to occur.
A Spanish laboratory has developed a formula for oral suspension recently. “The drug is called Bandol, it is a kind of liquid with a menthol flavor and allows several doses in a single vial,” specifies Martínez Salamanca, who comments that it is a pulsation system. “Depending on the number of pulses, the dose changes: four are 50 mg, six are 75 mg and eight are 100 mg”.
Is It Safe to Consume Alcohol While Taking Sildenafil Medication?
Take Sildenafil only once a day, and not to take it with food or alcoholic beverages, to achieve an optimal effect and prevent adverse effects, since it interferes with both fats and alcohol.
The pharmacist and researcher María Perelló, from the Official College of Pharmacists of Barcelona (COFB), explains that, when taken with food, “the onset of its pharmacological action could be delayed compared to when it is taken on an empty stomach”.
Romero-Otero gives an example of intake: “If you are going to have a romantic dinner, the logical thing to do is to take the pill an hour and a half beforehand so that it does not interact with food and so that you are covered before the 6 hours of its action are up”.
What Is the Appropriate Dosage for Sildenafil Medication?
Romero-Otero recognizes that the administration of Sildenafil “should be started -although most of the time it is not done-at the lowest dose, which is 50 mg per day, and if there is no response, it should be increased to 100 mg”. Try lowering ED medication to 25 mg when 50 mg achieves a good result.
The reason why they usually start with 100 mg daily and then go down to 50 mg if the response is adequate is that, since it is a “relatively expensive drug and not covered by the public health system, many patients who try the 50 mg dose, and it does not work for them do not want to go up to 100 mg”.
The dose used for the treatment of pulmonary hypertension is 20 mg three times a day.
What Are the Primary Risks and Potential Adverse Effects of Sildenafil Use?
The EUA representative stresses that Sildenafil is a very safe drug. The main risk is that derived from the consumption of doses higher than those recommended, which produce “a theft of blood to the heart because vasodilation occurs almost exclusively in the penis and most of the blood accumulates in the skin”. The most serious consequence is myocardial infarction.
The specialist cites as examples reddening of the face and ears, headache or back pain.
The pharmaceutical company refutes a common belief about the long-term effects of Sildenafil: “There is no evidence that it causes dependence”.
Is Sildenafil Available with or without a Prescription?
Sildenafil is dispensed in Spain with a prescription, but in the United Kingdom a presentation is marketed that does not require a prescription, called Viagra Connect.
Currently, this option is not foreseen in Spain or in the rest of the European Union. Romero-Otero considers that this is an interesting debate and believes that over-the-counter sales considered “provided that there is sufficient health education of the population” to control the risks.
Are There Any Viable Alternatives to Sildenafil Medication?
- Tadalafil
- Vardenafil
- Avanafil
- Udenafil