What Viagra Connect dosages can you choose from?
Most erectile dysfunction medications come in a range of dosages – is this the same for Viagra Connect?
Dosage for medications can affect how well the medication works, but also the risk of side effects. What does this mean for Viagra Connect?
What dosages of Viagra Connect are available?
At the moment 50mg is the only dosage available – Viagra Connect are blue tablets containing 50mg of sildenafil citrate. They are currently only available in this strength and come in pack sizes of 4, 8, 12, 16, or 28 tablets. The recommended dose for Viagra Connect is one 50mg tablet taken with water, one hour before sexual activity. The maximum recommended daily dosage is one 50mg tablet once per day.
You can get different dosages of the active ingredient – there are other dosages of the active ingredient sildenafil available on prescription as either ‘Sildenafil’ or ‘Viagra’. Both these alternative medications are available in dosages of 25mg, 50mg or 100mg.
More dosages could become available –  announced on 28th November 2017, Viagra Connect 50mg became available to buy Spring 2018. Other dosages may also become available in the future once the over-the-counter Viagra service is successful and established. Each dosage that may become available would need to undergo a reclassification and consultation process to ensure that it is safe.
How well does the 50mg dosage of Viagra Connect work?
Long term clinical studies have shown that, at 50mg, Viagra Connect is an effective and proven treatment for ED. 50mg of Viagra connect:
Works for 74% of men who try it Works within 25 minutes in 60% of men who try it Improves the response to sexual stimulation in 40.8% of men after the first dose Can last for up to 6 hours.
What if 50mg doesn’t work for me? – Most men usually respond after one or two doses but some may need up to six to eight doses. If you don’t experience satisfactory results with Viagra Connect after several attempts on different occasions, then speak to your doctor.
Could I try a different dosage? – other doses of 25mg or 100mg are available for Viagra or Sildenafil, but they are on prescription only. All doses available are effective and are licensed to be prescribed for ED.
Does 50mg work for everyone? – no. Some people may find they need to increase the dosage to get the results they’re looking for. For others, 50mg is not safe and 25mg needs to be used instead. You may also need a lower dose of 25mg if you are on other medication which may increase the effects of Viagra Connect:
Alpha blockers (alfuzosin, doxazosin, tamsulosin) – you need to be stable on alpha blocker treatment before you start taking Viagra Connect because there is a risk of low blood pressure when you stand up, from sitting down or lying down. It’s important to leave a gap of a least 6 hours between taking an alpha blocker and Viagra CYP3A4 inhibitors (ketoconazole, itraconazole, erythromycin, cimetidine) – with the exception of ritonavir 
If you have been previously diagnosed with severe kidney impairment, or mild to moderate liver impairment, then you must consult your doctor before taking Viagra Connect to check this is safe for you or whether a lower dose of 25mg would be more suitable for you.
What would happen if you increased the dosage of Viagra Connect?
2 things happen – the effect of Viagra Connect increases with taking a higher dosage but so does the risk of side effects.
How do you increase the dosage? – there is currently no way to increase the dose of Viagra Connect as it is only available in a dose of 50mg. The 100mg dose of the active ingredient, sildenafil citrate, is the only dose available that is higher than 50mg. If you think you need a higher dosage, you could consider prescription Sildenafil 100mg or Viagra 100mg, or ideally speak to your doctor.
You should always follow the dosage instructions of your doctor or pharmacist.  You should never increase the dosage by yourself.
What if I’ve taken more than 50mg a day? – seek urgent medical attention if you take too much Viagra Connect. Some of the symptoms of overdose include:
You must always call 999 or visit your nearest A&E department if you have an erection that lasts more than 4 hours – an erection lasting that long needs to be treated in hospital to prevent any permanent damage to the penis.
Can you combine Viagra Connect with other treatments?
Not other medications – PDE-5 inhibitors like Viagra Connect are not recommended for use with other treatments for ED. This includes:
Other PDE-5 inhibitors are called Tadalafil (Cialis), Vardenafil (Levitra) or Avanafil (Spedra) which are only available on prescription Other medications used to treat ED include Alprostadil, Papaverine, and Phentolamine  Yohimbine – a herbal extract that might interfere with Viagra Connect.
Are there studies on combining medications? – yes. There have been studies on combining alprostadil with sildenafil but this is currently not recommended because evidence is limited and there is concern about the risk of prolonged erections and side effects to the heart. Papaverine is not licensed but it can be prescribed for ED as a penile injection. Phentolamine can also be added if the response is inadequate but this is also not licensed.
You can combine Viagra Connect with treatments that don’t involve medication – there are other different ways ED can be treated other than medication, which could improve your chances of success with Viagra Connect, including:
It’s better to consider changing dosage or switching medications – if Viagra Connect is not working, then speak to your doctor. They may consider prescribing you a different dosage of sildenafil higher or lower dose depending on your medical history, other medication you are taking and your general condition.
Your doctor can also consider switching you to another PDE-5 inhibitor and adjusting your dosage depending on your response, before suggesting other options.
Can you increase the effects of Viagra Connect?
Yes, there are some things you can try to get the most out of your Viagra Connect.
Make sure you’re aroused – Viagra Connect will only work if you are sexually aroused. It does not have an effect on sexual desire.
Lifestyle changes can help support your Viagra Connect treatment – you could also make some lifestyle changes which will help with your ED such as:
Lose weight if you are overweight or obese Quit smoking Eat a healthy balanced diet Exercise daily Try to reduce any stress or anxiety Try to address any emotional problems through counselling Do not cycle for a while – if you cycle more than 3 hours a week Do not drink more than 14 units of alcohol in a week – excessive drinking of alcohol can temporarily reduce your ability to get an erection.
Keep other health problems under control – managing or preventing medical conditions through lifestyle changes such as diabetes, high blood pressure, high cholesterol will also help.
Avoid foods that affect the strength of Viagra Connect – grapefruit or grapefruit juice can boost the levels of Viagra Connect in your body and should be avoided as higher levels of Viagra Connect will increase the risk of side effects.
Avoid heavy meals beforehand – Viagra Connect can be taken with or without food. It is more effective if it taken without food particularly a high fat meal as this can delay the absorption of Viagra Connect and cause it to take a little longer to work.
Dosage is still the main factor – the main way to increase the effects of Viagra Connect is to increase the dosage, but this should always be done on the advice of your doctor. A higher dosage carries a higher risk of side effects.
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