Medical Review by Jennie Stanford, MD, FAAFP, DipABOM
Summary:
- Viagra blocks the enzyme PDE5 before it can break down cGMP—a hormone that helps increase blood flow to the penis by allowing muscles to relax and blood vessels to expand.
- Viagra is primarily used for erectile dysfunction but may also be prescribed off-label, at a healthcare provider’s discretion, to help treat pulmonary hypertension by expanding the blood vessels connected to the lungs.
- Most side effects of Viagra are mild and resolve themselves in a few days or weeks. Rarer and more serious side effects relating to muscle pain, hearing problems, or vision loss generally also go away once the use of the drug is discontinued. A small number of men taking Viagra have experienced heart complications, but there is no explicit link between Viagra and these events.
- Consulting our medical practitioners before you start taking Viagra or adjusting your dosage is vital for safe and effective use.
Viagra® guide: what is it?
Often referred to as “the little blue pill”, Viagra (and its generic form sildenafil) is one of only four FDA-approved medications for treating erectile dysfunction. But like any drug, there’s a right and wrong way to use Viagra—as well as a range of benefits and potential side effects.
Use this guide from our US-based medical team to get all the essential info you need before using Viagra. Below, we’ll tell you how to use this medication and what to avoid doing so that you can have the best possible results.
Introduction to Viagra® (sildenafil)
Viagra (known generically as sildenafil) inhibits PDE5, an enzyme responsible for breaking down the hormone cGMP. cGMP plays a key role in allowing blood flow to the muscles in the penis—so when it breaks down too fast, it becomes difficult to achieve and sustain an erection.
Many men who experience erectile dysfunction have regular levels of PDE5 but low levels of cGMP, which causes it to break down too soon. By blocking PDE5, Viagra allows cGMP to effectively help the muscles in the penis relax during arousal and makes getting an erection easier.
A quick history of Viagra®
- Sildenafil citrate was originally created in 1989 to help treat high blood pressure and angina.
- Clinical trials in the early 1990s revealed that many patients experienced increased erections after taking the drug.
- In 1996, sildenafil citrate was patented—and by 1998, Viagra (the brand-name version) was approved for use in the United States by the FDA as a treatment for erectile dysfunction.
Uses of Viagra®
Primary usage
Viagra is most commonly used for treating erectile dysfunction and improving sexual performance. Contrary to what some people believe, using Viagra does not automatically give you an erection. It only allows you to have an erection if you are already aroused.
Off-label uses
Viagra is also sometimes used to treat pulmonary hypertension—high blood pressure in the blood vessels supplying the lungs.
Pulmonary hypertension can cause damage to the right side of the heart and increase your risk of heart failure. By inhibiting PDE5, Viagra can widen the blood vessels connected to the lungs in the same way that it widens the blood vessels connected to the penile muscles.
Key benefits of Viagra®
- Improved sexual satisfaction: Viagra can allow men struggling with erectile dysfunction to engage in sexual activity more often and more consistently.
- Psychological benefits: Treating erectile dysfunction often leads to reduced anxiety around sexual performance, decreased stress, and an improved sense of well-being.
- Beneficial for relationships: By improving sexual function, Viagra can help restore intimacy and connection between partners that may have been affected by erectile dysfunction.
- Flexible timing: Viagra can be taken as needed, usually about an hour before sexual activity. This allows users to take the medication only when they plan on being sexually active.
- Non-invasive: As an oral medication, Viagra is non-invasive compared to some other treatments for erectile dysfunction like penile implants or injections.
Common side effects
Like almost any medication, Viagra® has potential side effects. Many of the most common side effects of Viagra are non-serious and resolve themselves within a few days or weeks of taking the drug:
- Headache
- Flushing
- Upset stomach
- Stuffy or runny nose
- Back pain
- Muscle pain
- Nausea
- Rash
Vision changes, dizziness, & muscle pain
Some men taking Viagra have reported the following:
- Feelings of dizziness or a loss of balance.
- Abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision. This normally goes away after several days of not taking the drug—but in the rare event that you experience any sudden loss of vision in one or both eyes, stop taking Viagra immediately and call your doctor. This can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION)—it’s not known whether PDE5 inhibitors can cause this.
- Muscle or back pain. This is normally mild to moderate and should resolve itself in a few days or up to two weeks.
Serious side effects and precautions
In rare cases, people taking Viagra have experienced more serious health problems:
- Priapism (a painful erection lasting over 4 hours). This can occur after taking too many PDE5 inhibitors, and it can cause permanent damage to the penis—if you experience it, seek medical attention immediately.
- Sudden loss of hearing in one or both ears. This may or may not be accompanied by tinnitus (a ringing in one or both ears). If you experience hearing issues while taking Viagra, stop taking it and contact your doctor as soon as possible.
- Heart conditions leading to heart attacks, strokes, irregular heartbeats, and sometimes death. These events occur only rarely, and almost always in men who had previous heart conditions before taking Viagra—it is not known whether Viagra was responsible for them.
Interactions & contraindications
Potential interactions with other medications
- Nitrates: Viagra should not be used with nitrates, often prescribed for chest pain, as the combination can lead to a dangerous drop in blood pressure.
- Blood pressure medications: Caution is advised when Viagra is used with certain blood pressure medications, such as alpha-blockers, as it can also lower blood pressure too much.
- HIV protease inhibitors: These medications can increase Viagra levels in the body, leading to increased side effects.
- Other PDE5 inhibitors or ED treatments: Concurrent use should be avoided to prevent excessive medication levels and increased risk of side effects.
See also: Is It Safe to Use Viagra & Cialis At the Same Time?
Dosage & administration
Starting doses
Viagra tablets come in three strengths:
- 25mg
- 50mg
- 100mg
Viagra is usually prescribed at a 50 mg dose, to be taken about one hour before sexual activity. However, depending on its effectiveness and the patient’s tolerance, this dose may be adjusted.
It is vital to take only the amount of Viagra that is prescribed to you by a doctor. Your dosage will be carefully determined based on your specific needs and health history.
Adjusting your dose
When recommended by a doctor, some individuals can increase their Viagra dose up to 100 mg or decrease it to 25 mg. These adjustments are typically made based on the individual’s response to the medication.
Learn more about Viagra® from Lemonaid Health
Viagra remains a potent treatment for erectile dysfunction in many people, but it’s essential to understand how it works so you can take it responsibly and reduce your risk of experiencing adverse effects.
If you have any unanswered questions about what Viagra can do for you, reach out to our online medical team for a consultation. We’re here to provide education and resources that help you find the healthcare support you need.
Frequently asked questions about Viagra®
When is using Viagra not recommended?
It is inadvisable to take Viagra if you have any of the following:
- Severe heart conditions (such as unstable angina)
- Recent strokes or heart attacks
- Severe liver or kidney disease
- Low blood pressure (hypotension)
What happens if you take more than the recommended dose of Viagra®?
Overdosing on Viagra can increase the risk of serious side effects. It’s essential to follow the dosage prescribed by your doctor and not take more than one dose per day.
Can you make Viagra® more effective without increasing the dose?
For maximum efficacy, follow these steps when taking Viagra:
- Take on an empty stomach for the best efficacy. A high-fat meal may delay how quickly the drug begins to work.
- Take Viagra 30-60 minutes before planned sexual activity—this is how long it can take for the results to appear.
- Remember that sexual stimulation is required after taking Viagra for it to be effective. Taking the medication will not automatically give you an erection.
Viagra® is a registered trademark of Pfizer Inc.
