During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect of sildenafil. Store at room temperature away from moisture and heat.
Potential Side Effects:
Viagra is usually taken only when needed, 30 minutes to 1 hour before sexual activity. You may take it up to 4 hours before sexual activity. Do not take Viagra more than once per day. Viagra can help you have an erection when sexual stimulation occurs. An erection will not occur just by taking a pill. Since Viagra is used as needed, you are not likely to miss a dose.
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Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
How oral medicines differ
Men on a date often go out to dinner, which are often large meals with plenty of fat content. Sildenafil, or Viagra, becomes less effective when metabolized along with a fatty meal. Therefore, Tadalafil is almost always a better choice, unless the patient is experiencing unacceptable side effects. Beyond the meal, men who are dating tend to be more spontaneous in their sexual endeavors than men in a longer-term relationship, and as such may not want to take a pill as often. Viagra/sildenafil is very much an in-the-moment ED medication.
Is Viagra’s dosage based on weight?
It takes about 45 minutes to an hour to kick in and lasts a few hours thereafter. On the other hand, Cialis/Tadalafil remains in the bloodstream for up to 36 hours (though its practical effectiveness wanes by the end of a day or so) If you have recently been diagnosed with erectile dysfunction and have been prescribed ED medications, Dr. Engel encourages patients to try and see which medication works better. Every patient is different, and there’s no telling which drug, if any, will create unacceptable side effects. As such, with the price of genetics as low as they are, we recommend buying some of each to see how they work.
Tadalafil (Cialis)
Typically, a urologist like Dr. Engel will prescribe the maximum dose, 100 mg for Viagra and 20 mg for Cialis. From there, we suggest cutting the pill in half to see if this is sufficient for sexual activity. Most patients try sildenafil for a couple of weeks and then tadalafil for a couple more. However, do not combine the drugs such that the dose exceeds the maximum daily intake, as this can cause significant side effects. Drinking alcohol with this medicine can cause side effects. Grapefruit and grapefruit juice may interact with sildenafil and lead viagra black to unwanted side effects. Avoid the use of grapefruit products while taking sildenafil. Avoid using any other medicines to treat impotence, such as alprostadil or yohimbine, without first talking to your doctor.
Brand Name
Prescription Required
Available at Pharmacies
Online Purchase Options
Generic Availability
Notes
Viagra
Yes
Wide
Yes
Yes
Official Pfizer product
Kamagra
No
Limited
Yes (online only)
Yes
Often obtained online
Caverta
Yes
Widely available
Yes
Yes
Popular generic alternative
Revatio
Yes
Prescription only
Yes
Yes
For pulmonary hypertension
Get emergency medical help if you have signs of an allergic reaction to Viagra: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
BlueChew: Subscription-based, chewable sildenafil/tadalafil, discreet, effective for ED, requires consultation. Erectaforce: Natural supplement with herbal ingredients, supports erectile function, but effectiveness varies individually. VigRX Plus: Herbal supplement claiming to boost libido and erectile health, not a direct substitute for medication.
Stop taking Viagra and get emergency medical help if you have: heart attack symptoms--chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating; heart attack symptoms--chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating; vision changes or sudden vision loss; or vision changes or sudden vision loss; or erection is painful or lasts longer than 4 hours (prolonged erection can damage the penis).
What to avoid
A prolonged erection (priapism) can damage the penis. Stop using Viagra and get emergency medical help if you have sudden vision loss. You should not use Viagra if you are allergic to sildenafil, or: if you take other medicines to treat pulmonary arterial hypertension, such as riociguat (Adempas). if you take other medicines to treat pulmonary arterial hypertension, such as riociguat (Adempas). Do not take Viagra if you are also using a nitrate drug for chest pain or heart problems.
Unbranded Sildenafil
This includes nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers"). To make sure Viagra is safe for you, tell your doctor if you have ever had: heart disease or heart rhythm problems, coronary artery disease; heart disease or heart rhythm problems, coronary artery disease; a heart attack, stroke, or congestive heart failure; a heart attack, stroke, or congestive heart failure; a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia; a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia; retinitis pigmentosa (an inherited condition of the eye); retinitis pigmentosa (an inherited condition of the eye); a physical deformity of the penis (such as Peyronie's disease); or a physical deformity of the penis (such as Peyronie's disease); or if you have been told you should not have sexual intercourse for health reasons. if you have been told you should not have sexual intercourse for health reasons. Viagra can decrease blood flow to the optic nerve of the eye, causing sudden vision loss.
More common
This has occurred in a small number of people taking sildenafil, most of whom also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoked or were over 50 years old. It is not clear whether sildenafil is the actual cause of vision loss. Viagra is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. It is not known whether sildenafil passes into breast milk or if it could harm a nursing baby. erection is painful or lasts longer than 4 hours (prolonged erection can damage the penis).
WebMD or Mayo Clinic: For reliable, medically-reviewed information on conditions and treatments. International Society for Sexual Medicine (ISSM): Professional society with patient resources. Urology Care Foundation: Patient education site from the American Urological Association. FDA Medication Guides: Official information on drug benefits, risks, and proper use. Peer Support Forums: Online communities (moderated) for sharing experiences and coping strategies.
Call your doctor at once if you have: ringing in your ears, or sudden hearing loss; ringing in your ears, or sudden hearing loss; swelling in your hands, ankles, or feet; swelling in your hands, ankles, or feet; a light-headed feeling, like you might pass out. a light-headed feeling, like you might pass out. abnormal vision (blurred vision, changes in color vision) abnormal vision (blurred vision, changes in color vision) This is not a complete list of side effects and others may occur.
Red Ginseng: Some clinical evidence suggests it may be beneficial for mild ED. L-citrulline: Converts to L-arginine in the body, potentially improving blood flow. Horny Goat Weed (Icariin): Traditional remedy, but modern extracts are under research. Pycnogenol (Pine Bark Extract): Sometimes combined with L-arginine in studies. DHEA Supplements: Precursor hormone; may help only if levels are deficient.
You may report side effects to FDA at 1-800-FDA-1088. Do not take Viagra with similar medications such as avanafil (Stendra), tadalafil (Cialis) or vardenafil (Levitra). Tell your doctor about all other medications you use for erectile dysfunction.
Comparing Side Effects
At some point, the medication may cease to offer the benefit it once did, and this is to be expected after many years of use. Remember that most cases of ED are progressive and caused by vascular issues – specifically blood flow to the penis. To that end, unless the patient has improved their diet and exercise regimen tremendously, which will often be evident in their erections, the dysfunction will progress until the pills no longer work. At this point, speaking to a qualified urologist like Dr. Engel about the next steps, including penile injections, and a penile implant is a good next step.
Vardenafil (Levitra) or Avanafil (Stendra)
Generic name: sildenafil (oral) [ sil-DEN-a-fil ] Other brand names of sildenafil (oral) include: Revatio, Viagra, Vybrique Drug class: Impotence medications Viagra relaxes muscles found in the walls of blood vessels and increases blood flow to particular areas of the body. Viagra is viagra packaging used to treat erectile dysfunction (impotence) in men. Another brand of sildenafil is Revatio, which is used to treat pulmonary arterial hypertension and improve exercise capacity in men and women. This page contains specific information for Viagra, not Revatio. Do not take Viagra while also taking Revatio, unless your doctor tells you to.
Heart health and erectile dysfunction
Some medicines can cause unwanted or dangerous effects when used with Viagra. Tell your doctor about all your current medicines, especially riociguat (Adempas) and nitrates. Do not take Viagra if you are also using a nitrate drug for chest pain or heart problems, including nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, and some recreational drugs such as "poppers". Taking sildenafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure. Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours. Tell your doctor about all your current medicines and any you start or stop using, especially: drugs to treat high blood pressure or a prostate disorder; drugs to treat high blood pressure or a prostate disorder; medicine to treat HIV/AIDS - atazanavir, indinavir, ritonavir, or saquinavir; medicine to treat HIV/AIDS - atazanavir, indinavir, ritonavir, or saquinavir; medications used to treat pulmonary artery hypertension. medications used to treat pulmonary artery hypertension. Other drugs may interact with sildenafil, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Brand Name
Common Side Effects
Rare Side Effects
Contraindications
Warnings
Viagra
Headache, flushing, nasal congestion
Vision changes, dizziness
Nitrate medications, heart conditions
Use with caution in cardiovascular disease
Kamagra
Dizziness, nausea
Priapism, allergic reactions
Heart issues, or if allergic to Sildenafil
Not approved in some countries
Caverta
Flushing, stomach upset
Sudden vision loss
Nitrate drugs, allergy to sildenafil
Consult doctor if side effects persist
Revatio
Headaches, muscle pain
Hearing loss, vision disturbances
Similar to Viagra contraindications
Needs doctor supervision
You can take Viagra (sildenafil) if you have high blood pressure that is controlled by blood pressure medications.
How should I take Viagra?
Tell your doctor if you are breast-feeding a baby. Do not give this medicine to anyone under 18 years old without medical advice. Take Viagra exactly as it was prescribed for you. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. You should tell your doctor if you have high or low blood pressure before starting Viagra. Cialis (tadalafil) and Viagra (sildenafil) are both prescription drugs used to treat erectile dysfunction (ED), but taking them together is generally not recommended. Mixing these medications can lead to dangerously low blood pressure and a higher risk of side effects. It takes from 30 minutes to 1 hour for Viagra (sildenafil) to start working, and the effects will last for about 4 hours. Viagra (sildenafil) is approved to treat sexual dysfunction in men by the U.S.
KAMAGRA (Sildenafil Jelly): Easy to take, fast-acting, popular in some regions as an alternative to pills, buy responsibly. Apcalis SX: Tadalafil variant, quick onset, lasts longer, ideal for flexible timing in intimacy. Penegra: Generic sildenafil citrate, affordable, effective, but always ensure purchase from reputable sources.
Food and Drug Administration (FDA), but it is sometimes prescribed to women off-label, which means without approval by the FDA. Viagra is an effective drug for treating male erectile dysfunction, but it targets sexual performance, not sexual arousal.
