How often can I take Sildenafil?

How SEX affects the body

When a man is sexually excited, the penis rapidly fills with more blood than usual. With this extra flow of blood, the penis then expands and hardens. This is an erection. After the man is done having sex, this extra blood flows out of the penis back into the body. The erection goes away.

In an opposite extreme situation, if an erection lasts for a long time (more than 6 hours), it can permanently damage your penis. You should call a doctor immediately if you ever have a prolonged erection that lasts more than 4 hours.

During sex, your heart works harder. Therefore sexual activity may not be advisable for people who have heart problems. Before you start any treatment for erectile dysfunction, ask your doctor if your heart is healthy enough to handle the extra strain of having sex. If you have chest pains, dizziness or nausea during sex, stop having sex and immediately tell your doctor you have had this problem. Some conditions and medicines interfere with the natural erection process. The penis cannot fill with enough blood. The man cannot have an erection. This is called erectile dysfunction if it becomes a frequent problem.

Erectile dysfunction. I have it. Can I hide it?

No. Erectile dysfunction is a serious problem that can affect both the young and the old, involving psychological causes in some cases.

Erectile dysfunction, defined today as the inability to attain and maintain an erect penis with sufficient rigidity for sexual intercourse, has become an increasingly common complaint that affects 140 million men worldwide. Risk factors for developing erectile dysfunction include age, diabetes, hypertension, obesity, lack of exercise, dyslipidemia, smoking, depression, lower urinary tract symptoms, and pelvic surgery.

So, suffering from erectile dysfunction is a serious condition with a markedly negative impact on quality of life.

Sexologists say that most of the underlying causes of impotence involve blood vessels. Smoking, diseases like diabetes, heavy drinking and heart problems can all lead to blood vessel obstruction and therefore impotence, whilst emotional issues can exacerbate the problem.

The good news is that we can handle it.

Is a magic treatment available, that can make it work again?

Some call it the blue pill. Some call it the secret of happiness. But worldwide it is known as Viagra.

Magic in a pill? No, just Chemistry.

Among other treatments that are nowadays available for erectile dysfunction, Viagra was the first. So Viagra stands out as the pioneer of drugs that treat erectile dysfunction, for twenty years. It made men confident again and revived couples. Sildenafil citrate was the first oral agent to be introduced for the treatment of erectile dysfunction, thanks to the researchers from Pfizer.

Sildenafil is a highly selective inhibitor of PDE type 5 2,3 and enhances NO-mediated relaxation of human corpus cavernosum. Sildenafil, by inhibiting phosphodiesterase, increases the intracellular concentrations of cyclic guanosine 3’,5’ monophosphate (cGMP), causing an amplification of the endogenous NO-cGMP signalling pathway. It is considered a vasodilator agent, acting by increasing blood flow to the penis and thus it restores impaired erectile function.

Viagra is associated with rapid onset of action – within 14 minutes for some men – and an extended duration of action for up to 12 hours. 5 In order for Viagra to be effective, it requires sexual stimulation in a natural setting.

The “blue tonic” rejuvenated hundreds of couples. It is used worldwide. Some use it for years. Some just want to try it.

Can I have Viagra and Sildenafil?

It is the same thing. Sildenafil is the active substance of Viagra, while Viagra is the commercial name. There are also generics of sildenafil available. Teva’s generic Viagra has launched already in December 2017 in the United States. Pfizer recently started to sell the new generic version of Viagra. Not only the generic is cheaper than the original drug but it is also easy to buy over the internet from legitimate UK pharmacy’s. Thus stopping any awkward face to face conversations.

The legend of the blue pill remains but generic alternatives can be used with the same effects, administering the same medicine (sildenafil) but with some extra money in the pockets of the patients.

So, how many strengths of Viagra/Sildenafil are there?

The original Viagra comes in three concentrations: 25, 50 and 50 mg.

For most patients, the recommended dose is 50 mg taken, as needed, approximately 1 hour before sexual activity. However, VIAGRA may be taken anywhere from 4 hours to 0.5 hours before sexual activity. Based on effectiveness and toleration, the dose may be increased to a maximum recommended dose of 100 mg or decreased to 25 mg. The maximum recommended dosing frequency is once per day. 4

For Sildenafil tablets, it is the same.

I take 50 mg of sildenafil. What happens?

Immediately after ingestion of one tablet, Sildenafil starts to absorb into the body.

Sildenafil has a rapid onset of action.

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 a mean delay in Tmax of 60 minutes and a mean reduction in Cmax of 29%. 7

Pharmacokinetic studies have supported the suitability of single oral doses of sildenafil for an as-needed and on-demand treatment for erectile dysfunction. In healthy volunteers, sildenafil doses are absorbed rapidly, with maximum plasma concentrations achieved within a median time of 1 h (range 0.5–2 h) after dosing.

The terminal half-life of sildenafil is 3–5 h.

In a two randomised, double-blind, placebo-controlled, two-way crossover studies were conducted in men with erectile dysfunction of no known organic cause, sildenafil proved to be an effective oral treatment for erectile dysfunction that produces a penetrative erection as early as 12 min and for most patients, within 30 min after dosing, and a duration of action lasting at least 4 h. 8

The volume of distribution and clearance characteristics of sildenafil resulted in an apparent terminal half-life ranging from 3 to 4 h. The half-life of sildenafil provides for an appropriate duration of therapeutic effect and also prevents drug accumulation with chronic once-daily use.

In a 4-year study, only 3.8% of the men had 1 or more adverse events that led to changes in dosing. Of the 47 events that were documented during the study period, headache and dyspepsia were most common (10 events each), followed by rhinitis (6 events), flushing (5 events), abnormal vision (4 events), dizziness (3 events), and 1 report each of mild palpitations, moderate tachycardia, diarrhea, nausea, myalgia, hypertonia, respiratory disorder, conjunctivitis, and photophobia. Of the few cardiovascular events determined by the investigator to be treatment-related (4 cases of mild flushing and 1 each of moderate flushing, mild palpitations, and moderate tachycardia), only 1 led to permanent discontinuation of treatment. In this case, the man experienced mild flushing with the first dose of sildenafil 100 mg but continued therapy after a dose reduction. Two other cardiovascular events led to temporary discontinuation (mild flushing and moderate tachycardia), and the remainder were addressed with a change in dosing. 9

So, how often can I take Sildenafil?

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.

You can take one tablet daily if you’re in the mood for love.

Sildenafil usually should not be taken more than once.

You should not take sildenafil every day if you do not intend to have sex every day. Sildenafil does not have a cumulative effect, which means that the active substance is not accumulated in the tissues of your penis even if you take it daily. Thus, you will not have better or constant erections just because you ingested more Sildenafil “in advance”.

Sildenafil/Viagra just does not work that way.

We strongly recommend taking a pill only on those days on which you intend to have a sexual intercourse.

Is it safe?

Yes, Viagra is a safe drug. Safety was proven in a number of clinical studies. Sildenafil was administered to more than 9500 patients aged 18-87. 4

The safety of Viagra has not been studied and therefore is contraindicated in the following groups: a patient with severe hepatic impairment, a patient with hypotension (blood pressure <90/50 mmHg), a recent history of stroke and known hereditary degenerative retinal disorders such as retinitis pigmentosa.

The most common adverse reactions include a headache, flushing, dyspepsia, nasal congestion, dizziness, nausea and altered vision.

As dizziness was reported in clinical trials, it is better not to drive or to manipulate any operating machinery immediately after taking Viagra.

From all the drugs belonging to the class of PDE5 inhibitors, Viagra is preferred if you want to minimize side effects as it gets out of your system faster.

Contraindications

Consistent with its known effects on the nitric oxide/cGMP pathway, Sildenafil was shown to potentiate the hypotensive effects of nitrates, and its administration to patients who are using organic nitrates, either regularly and/or intermittently, in any form is therefore contraindicated. After patients have taken sildenafil, it is unknown when nitrates, if necessary, can be safely administered.

Sildenafil is contraindicated in patients with a known hypersensitivity to any component of the tablet.

Precautions

You cannot take any other PDE5 inhibitors on the same day when administering sildenafil, as there are risks related to overdosing. Please be careful when taking Cialis or tadalafil. You must wait 48 hours for wash-out before taking sildenafil. Consult our doctor for any additional questions related to any drug interactions.

Please also consider your degree of cardiac risks associated with the sexual activity.

If you are in the case of co-administering substances known to lead to symptomatic hypotension (blood pressure <90/50 mmHg), do not take Viagra.

If using alpha- blockers, you should address to your doctor prior to taking Viagra.

Sildenafil or Viagra cannot be administrated with nitric oxide donors or nitrated in any form (Nitroglycerin Isosorbide, Nitroprusside, Amyl nitrite or amyl nitrate). Nitrate esters are commonly used in the treatment of angina pectoris, or “chest pain”, myocardial infarction, and congestive heart failure. The combination of nitrates and Viagra can lead to a dangerous fall in your blood pressure. 10

Also, do not take nitrate-containing medicines up to 24 hours after you take Viagra.

If you are not certain, it is better to ask the doctor or the pharmacist.

Do not take Viagra if you are taking riociguat used to treat high pressure in the lungs and high pressure in the lungs secondary to blood clots, as their hypotensive effects may be increased by Viagra.

If you have a severe heart problem if you suffered a stroke or heart attack, or if you have a severe liver problem, it is better to refer to your doctor or pharmacist.

A regular use of sildenafil can affect me in any way?

A regular use of the drug helps a patient to be successful in the intimate sphere. Once again, we want to assure all men that even the long and frequent reception of Viagra can have absolutely no negative impact on their body.

What if I experience a problem?

If any unpleasant effects appear, please address directly to our pharmacy and to our doctor at phone number 0161 707 6800.

Viagra is the ideal oral treatment with plenty of advantages: great compliance in administration, a reasonably short time of action onset, reliable efficacy, good tolerability, high selectivity for the site of action, lack of central nervous system effects, rapid absorption that yields prompt onset of action and a plasma half-life that produces an appropriate duration of action while avoiding accumulation upon repeated once-daily use.

Still, we advise to report us any unusual reaction or any unusual effect.

And, to take sildenafil exactly as your doctor tell you to.

Also, if you feel the tablets are too strong for you, your dose may be reduced.

Please let us know if this is the case.

So, what should be my real expectations after taking Viagra for the first time?

Viagra will not make your penis larger and neither won’t decrease premature ejaculation. It will, however, decrease your refractory time, the time required to achieve a subsequent erection after ejaculation. And it will allow a firmer erection with less stimulation and will make possible a few more erection during the interval of 4-5 hours postdose. And the good news is that you can order it online. An evaluation from our pharmacist is necessary to confirm if Viagra/sildenafil is the appropriate medicinal product for you.

In summary…

The definition of erectile dysfunction can be different for every guy. Also, the treatment can be different depending on a lot of factors.

Remember, this medicine is for you. Do not share it with others.

Being a Viagra patient for the first time, you may experience unwanted effects. They are transitory and often improve as your body adjusts to the new medicine.

If you have any questions related to this medicine, please write us or call the number

01625 460 621 and our doctor will advise you further.

There are many illegal sources that sell Viagra so be careful when you purchase sildenafil or Viagra.

Viagra film-coated tablets are blue, with a rounded diamond shape. They are marked “PFIZER” on one side and “VGR 50” on the other side.

Assured Pharmacy is an approved and authorized online pharmacy to sell Viagra and other medicines. You must complete an online questionnaire and afterwards, a GMC regulated doctor will issue a prescription that allows you to acquire Viagra or sildenafil in an efficient, safe and regulated manner.

This prescription is sent directly to our pharmacy where it is checked by a qualified pharmacist to ensure the treatment is suitable.

The more we think or speak about it, the more we agree on the following:

  1. Viagra is not an aphrodisiac;
  2. Viagra won’t make you bigger;
  3. Viagra does not compensate you with energy so work your body as sex consumes a lot of energy;
  4. Viagra does not treat premature ejaculation;
  5. Viagra is a treatment, not a cure.

At last, we wish you a Happy Valentine’s (we really think that the candles, champagne and the strawberries will make a really nice Valentine present).

References

  1. M Boolell M, MJ Allen, SA Ballard, S Gepi-Attee, GJ Muirhead, AM Naylor, IH Osterloh, C Gingell – Sildenafil: an orally active type 5 cyclic GMP-specific phosphodiesterase inhibitor for the treatment of penile erectile dysfunction;
  2. E Gbekor, S Bethell and L Fawcett- Selectivity of sildenafil and other phoshodiesterase type 5 (PDE5) inhibitors against all human phoshodiesterase families;
  3. Rodríquez Vela L, Gonzalvo Ibarra A, Pascual Regueiro D, Rioja Sanz LA.- Erectile Dysfunction;
  4. http://www.ema.europa.eu/Viagra- Summary of product characteristics;
  5. K Hatzimouratidis- Sildenafil in the treatment of erectile disfunction: an overview of the clinical evidence;
  6. http://www.bbc.com/news/health-42155489;
  7. https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/020895s027lbl.pdf;
  8. I Eardley, P Ellis, M Boolell, M Wulff-Onset and duration of action of sildenafil for the treatment of erectile dysfunction;
  9. Murray J et al- Long-term safety and effectiveness of sildenafil citrate in men with erectile dysfunction, Ther Clin Risk Manag. 2007 Dec; 3(6): 975–981;
  10. KE Torfgård, J Ahlner – Mechanism of actions of nitrates.

Mens Pharmacy is not liable for the currency or accuracy of the information contained in this blog post. For specific information about your personal medical condition, please contact our doctors or pharmacists for advice on [email protected] .

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