VIAGRA (SILDENAFIL) FOR ERECTILE DYSFUNCTION (ED)

25mg – reduced dose for those with medical history and prone to side-effects. Sometimes reduced from 50mg if very effective to reduce risk of side-effects, even if no medical history.

Leading points near picture (green tick:).

Take 30-60 minutes before sex
Lasts up to 4-5 hours
Effective in over 7/10 men

Do not take more than 1 tablet within 24 hours.

About Viagra

Viagra is a potent drug containing the active ingredient Sildenafil. This helps men keep and maintain an erection. Viagra does not work without arousal.

It is part of a group of medications called Phosphodiesterase 5 inhibitors (PDE-5 inhibitors)

It relaxes and opens up the blood vessels around the penis – allowing more blood to flow to the penis when excited.

More information on Viagra

Click to access pil.8725.pdf

Who can and cannot take Viagra

Suitability checker questionnaire:

18-64 – recommended starting dose 50mg

65+ start on 25mg for less risk of side effects.

Do NOT take if:

Recent heart attack
Recent stroke
History of serious eye problems, especially ones that affect vision:
Recent episodes of serious chest pain, sickness, dizziness or shortness of breath (known as angina, unstable)
Low blood pressure (Below 90 top number, systolic)

CAUTION: Consult a doctor or other healthcare professional before using:

Current stomach ulcer
Deformed penis
History of long, painful erection known as priapism
Other heart or blood disorders
Neurological, nervous-system issues
Predisposition to low blood pressure.

OTHER WARNINGS:

Avoid grapefruit juice as it can increase Viagra levels in the body, leading to increased side effect risk and severity.

SIDE EFFECTS

Most common include (around 1 in 10)

Anxiety
Digestive system disruptions
Back pain
Vision changes
Trouble sleeping
Headache
Increased infection risk

Uncommon (around 1 in 100)

Irregular heartbeat
Chest pain
Enlarged breast tissue (gynaecomastia)
Increase or decrease in blood pressure
Heart palpitations

Rare but serious (less than 1 in 1000) – STOP TAKING AND SEEK IMMEDIATE MEDICAL ATTENTION

Seizure
Passing out
High eye pressure (glaucoma)
Blood in ejaculate
Sudden heart stop
Severe skin reactions
Prolonged painful erection lasting for many hours (priapism)

STOP TAKING IF ANY VISUAL DISTURBANCES OCCUR AND SEEK IMMEDIATE MEDICAL ATTENTION

How to take sildenafil:

Ideally 30-60 minutes before the deed.
Can take up to 4 hours before however.

Viagra with other medications:

Interactions include:

Angina medication used recently – including nitrates – best to avoid
Blood pressure medications – blood pressure should be stabilised first then introduce Viagra at the lower dose (25mg)
Antivirals
Riociguat – for high blood pressure in the lungs
Anti-cancer chemotherapy drugs
Antifungals
Any other medications that can lower blood pressure

Viagra alternatives:

Cialis (Tadalafil – lasts up to 36 hours. EXTREMELY LONG LASTING. Spontaneity)
Vardenafil (lasts longer than Viagra)
Alprostadil cream – for those who don’t like taking tablets or have swallowing difficulties

Recommended lifestyle changes to help:

Smoking – quit smoking
Alcohol – moderate alcohol consumption
healthy weight
Avoid party drugs
Stress management – performance anxiety – psychological interventions
Exercise/diet

Viagra ingredients:

Tablet core:

microcrystalline cellulose

calcium hydrogen phosphate (anhydrous)

croscarmellose sodium

magnesium stearate

Film coat:

hypromellose

titanium dioxide (E171)

lactose

triacetin

indigo carmine aluminium lake (E132)

FAQ:

What if Viagra doesn’t work?

Timing of dose:
- Taking too early or late. 30 minutes to 4 hours before ideally.
- May need a dose adjustment to a higher dose if safe to do so.
- Alternative medications:
  - Tadalafil
  - Avanafil
  - Sildenafil
  - Alprostadil cream
- Must be sexually aroused; will not work without arousal.
Moderate ED – can use penis pumps to help
As a last resort, if all pharmaceutics fail, we can refer you to an Endocrinologist (specialised doctor around hormones) for further examination. Hormonal problems are likely the cause here.