What is Viagra?
Viagra is a PDE-5 inhibitor approved by the FDA to treat erectile dysfunction. Viagra is the brand name of the specific drug made by Pfizer. The active chemical in the medicine is sildenafil citrate.
Viagra was originally created in 1989 by Pfizer as a treatment for high blood pressure and chest pain but was discovered to help erectile dysfunction (ED). It became available in the US as an ED treatment in 1998 and has been widely prescribed ever since. In 2017, generic sildenafil became available at a much lower cost than the brand-name medication. Lemonaid doctors or nurse practitioners prescribe both Viagra and generic sildenafil so whatever you need when it comes to meds, we’ve got you covered.
What is Sildenafil?
Sildenafil and Viagra work the same; they’re equally effective, require the same amount of time to take effect, and they work for the same duration. The main difference between Sildenafil and Viagra is the branding and the price. Viagra tablets inevitably cost more than the generic Sildenafil medication.
Sildenafil is the active ingredient in Viagra and “generic Viagra,” but those aren’t the only medications that use it. In fact, it’s approved by the FDA in the treatment of conditions other than ED. Sildenafil is also used in Revatio, which treats pulmonary arterial hypertension (PAH), a condition in which the pressure in blood vessels that carry blood from your heart to your lungs is higher than normal (Barnett, 2006).
One big difference between Revatio and the sildenafil-based medicines that have been approved by the FDA for the treatment of ED is the dose. Revatio comes in only one dose, 20 mg. Viagra and generic Viagra come in three doses: 25 mg, 50 mg, and 100 mg. But there’s also generic Revatio, which also uses sildenafil as its active ingredient. Generic versions of this PAH medication can be used off-label to treat ED and has many more dosing options. In addition to the 20 mg dose Revatio comes in, these can also be prescribed in 40 mg, 60 mg, 80 mg, and 100 mg doses. Considering these medicines for the treatment of ED also makes it easier to work with healthcare providers on finding the right dose to maximize the effects of sildenafil that make erections easier while minimizing potential side effects.
What is generic Viagra?
“Generic Viagra” is another term for medicine with the active ingredient and dosage as Viagra, but it is not sold under the brand name. These generic drugs and Viagra are bioequivalent, which means they act the same way and produce the same results in the body. These medicines are also approved by the FDA to treat erectile dysfunction. In fact, they differ from Viagra in only two ways: first, these sildenafil tablets may not be produced by Pfizer, and second, they cost a lot less.
It’s important to note that, like the effects of Viagra, the effects of these generic medications don’t include spontaneous erection. Sexual stimulation is still needed for an erection. They simply make it easier to get and keep one.
Which one is right for me?
Since they have the same active ingredient, Viagra, generic Viagra, and sildenafil help combat erectile dysfunction in the same way. It also means they have the same potential side effects, such as low blood pressure, nasal congestion, indigestion, headaches, facial flushing, back pain, and sudden loss of hearing or vision. They both may also cause priapism, a persistent and painful erection that can last more than four hours. You’ll need to talk to your healthcare provider if you’re considering either, as they have the same drug interactions, including nitrates (like nitroglycerin).
Choosing between these erectile dysfunction medications comes mostly down to cost. Branded Viagra can be up to $70 a pill, while off-label sildenafil can be as low as $2. That’s a question for you, your insurance provider, and your budget. A healthcare professional can help you figure out which dose of either is right for you.
How does Viagra work?
Viagra is one of the best-known drugs of all time. Nearly every adult in America has heard of the drug and can tell you what it does.
In the years since it was introduced in 1998, former Republican presidential nominee Bob Dole has served as a spokesman for the drug, manufacture of counterfeit pills has gone through the roof, and Viagra talks are now a permanent feature of the pop culture landscape.
What’s the big deal about the little blue pill?
It’s simple: When it works as intended, Viagra causes a man who is sexually stimulated to get an erection.
How does Viagra do that? And why does Viagra work only if the man is sexually stimulated? For that matter, what causes an erection in the first place? In this article, we’ll answer all of those questions and more.
This is a fascinating story it involves the technology of the human body and the techniques that scientists use to control its different parts with drugs. And in the case of Viagra, the story starts with the penis.
To better understand how Viagra works, it helps to understand how the penis works as well.
For many people, talking about the penis is tough. This area of the body is considered private and isn’t discussed publicly (well, not in polite company). However, the penis is simply a part of the male anatomy designed to accomplish a task, and we’ll treat it that way here.
In the case of the penis, there are actually two tasks that it handles:
- releasing urine from the bladder, known as urination
- releasing sperm and seminal fluid from the prostate gland, known as ejaculation
Viagra helps with the second task: ejaculation.
When things are working properly, ejaculation is a three-step process:
- The man becomes sexually aroused.
- The penis responds by becoming erect.
- Stimulation of the penis causes ejaculation.
That sounds simple enough, but in many cases, step two doesn’t happen, making step three difficult or impossible. Although the man is stimulated, the penis doesn’t become erect. To understand why, you need to understand the technology of an erection.
Erections work kind of like a balloon filled with pressurized blood instead of pressurized air.
Viagra – technology of Erection
When you want to move nearly any part of your body, you do it using muscles. Whether you’re moving your fingers, toes, arms or legs, muscles do the work. Even when you stick your tongue out, you do it using muscles:
- You think about moving some part of your body.
- The appropriate muscles contract.
- That part of the body moves.
Muscles let you move your body voluntarily with precise control.
The penis, on the other hand, is completely different. There are no muscle contractions involved in making the penis erect. To become erect, the penis instead uses pressure.
The penis handles two tasks: urination and ejaculation.
Probably the easiest way to understand how the penis becomes erect is to think about a balloon. If a balloon has no air in it, it’s limp. As you inflate a limp balloon with just a little air, it becomes elongated and rigid.
The penis uses a similar mechanism, but instead of using pressurized air to become rigid, the penis uses pressurized blood. The penis contains two cigar-shaped structures, called corpora cavernosa (singular: corpus cavernosum), that it uses to become erect.
Think of the corpora cavernosa as balloonlike tubes. Arteries bring blood into these two tubes, and veins carry blood away from them. The penis can be either limp or erect, depending on the flow of blood:
- In a non-erect state, the arteries that transport blood into the corpora cavernosa are somewhat constricted, while the veins that drain the blood from the penis are open. There is no way for pressure to build inside the penis. In this state, the penis is limp.
- When a man becomes aroused, the arteries leading into the penis open up so that pressurized blood can enter the penis quickly. The veins leaving the penis constrict. Pressurized blood is trapped in the corpora cavernosa, and this blood causes the penis to elongate and stiffen. The penis is erect.
If the arteries leading to the penis don’t open up properly, it’s difficult or impossible for a man’s penis to become erect. This problem is the leading cause of erectile dysfunction (ED).
To solve an erection problem when the cause is poor blood flow, you need to open the arteries. Let’s take a look at how this can be done and how it was done before Viagra.
Smooth muscle plays a key role in every erection.
Viagra works by increasing blood flow to your penis. It’s a reliable treatment for men who are unable to achieve an erection and those unable to maintain an erection. If you’re struggling with erectile dysfunction, this might be the right ED medicine for you.
So what exactly does Viagra do? By relaxing the arteries and muscles in the penis, this medication helps increase blood flow to the area. When you experience sexual arousal after taking this medicine, blood flows through the relaxed arteries to your penis, allowing you to achieve and maintain an erection. But don’t worry, you won’t get a spontaneous erection just from taking a pill. You have to be sexually aroused after taking this medicine to get an erection.
Viagra is the most popular branded medication on the market for erectile dysfunction and has helped many men suffering from ED. Need help figuring out which is the right ED med for you? Schedule an easy online appointment with one of our doctors or nurse practitioners right now. We know how much privacy and discretion matter when it comes to your sexual health. That’s why we offer convenient video appointments with medical professionals from the comfort of your own home and ability to message our medical team anytime. Plus, our online pharmacy will deliver meds to your door in discreet packaging in just 2-3 days. We’ve got you covered.
When you swallow it in pill form, the cGMP component dilates the blood vessels and allows blood to flow more easily.
While this is happening, the drug stops the function of an enzyme in the penis called PDE5, which reduces blood flow.
So it allows blood to flow more freely into the penis, making it easier for men to achieve an erection.
Of course, everyone’s dose of the little blue pill is different and factors like age, general health and other medications can all have an impact on how effective it is for you.
Food also changes the way you react to it. Taking Viagra with a meal can mean you have to wait longer for it to kick in.
While Viagra is a widely accepted treatment for erectile dysfunction, many men still struggle to discuss the health issue openly.
Why is Viagra prescribed?
Sildenafil (Viagra) is used to treat erectile dysfunction (impotence; inability to get or keep an erection) in men. Sildenafil (Revatio) is used to improve the ability to exercise in adults with pulmonary arterial hypertension (PAH; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness). Children should not usually take sildenafil, but in some cases, a doctor may decide that sildenafil (Revatio) is the best medication to treat a child’s condition. Sildenafil is in a class of medications called phosphodiesterase (PDE) inhibitors. Sildenafil treats erectile dysfunction by increasing blood flow to the penis during sexual stimulation. This increased blood flow can cause an erection. Sildenafil treats PAH by relaxing the blood vessels in the lungs to allow blood to flow easily.
If you are taking sildenafil to treat erectile dysfunction, you should know that it does not cure erectile dysfunction or increase sexual desire. Sildenafil does not prevent pregnancy or the spread of sexually transmitted diseases such as human immunodeficiency virus (HIV).
How should Viagra be used?
Sildenafil comes as a tablet and suspension (liquid; Revatio only) to take by mouth.
If you are taking sildenafil to treat erectile dysfunction, follow your doctor’s directions and the guidelines in this paragraph. Take sildenafil as needed before sexual activity. 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. Sildenafil usually should not be taken more than once every 24 hours. If you have certain health conditions or are taking certain medications, your doctor may tell you to take sildenafil less often. You can take sildenafil with or without food. However, if you take sildenafil with a high-fat meal, it will take longer for the medication to start to work.
If you are taking sildenafil to treat PAH, follow your doctor’s directions and the guidelines in this paragraph. You will probably take sildenafil three times a day with or without food. Take sildenafil at around the same times every day, and space your doses about 4 to 6 hours apart.
Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take sildenafil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Shake the liquid well for 10 seconds before each use to mix the medication evenly. Use the oral syringe provided with your medication to measure and take your dose. Follow the manufacturer’s directions to use and clean the oral syringe. Do not mix the liquid with other medications or add anything to flavor the medication.
If you are taking sildenafil for erectile dysfunction, your doctor will probably start you on an average dose of sildenafil and increase or decrease your dose depending on your response to the medication. Tell your doctor if sildenafil is not working well or if you are experiencing side effects.
If you are taking sildenafil for PAH, you should know that sildenafil controls PAH but does not cure it. Continue to take sildenafil even if you feel well. Do not stop taking sildenafil without talking to your doctor.
Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.
Other uses for this medicine
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
How long does Viagra last?
A recent study by Superdrug looked into the effects of sildenafil – which is the medical term for the erectile dysfunction drug – to see how men reacted in the first 24 hours after taking it.
Here’s what happens:
First 12 minutes
Viagra is quickly absorbed by the body and some men with erectile dysfunction can get an erection just 12 minutes after gobbling the meds.
If it hasn’t happened for you in the first 12, then you’re probably going to get hard within the first half an hour.
Researchers found that the average response time to Viagra was just 27 minutes – even though doctors say you should wait an hour before seeing results downstairs.
After nearly an hour has passed, you’ll reach your “maximum erection potential” because the drug reaches its highest concentration in the blood. This is why experts say you should pop it one hour before sex.
According to the study, men can have erections that last up to 33 minutes within an hour of taking the drug.
Viagra has a half-life of about four hours, which means that every four hours after taking it, the drug reduces by 50%. But it’s still possible to have sex.
Scientists found that after 10 hours men could still get a strong erection. In fact, it was just as easy as when they got one 2 hours after dosing up.
Many lads can still get it up, but it won’t last as long. The average time that an erection lasts for is 16 minutes.
After one day the effects of sildenafil will have worn off. Almost all traces of the drug disappear from the blood stream, along with any boost to sexual performance.
Once you’ve taken your meds, you can expect peak performance for 2-3 hours. After that, the effects will slowly start to dissipate in your system. Still, for some men, this medicine can last up to 8 hours. There are many different factors that account for how long this medication lasts in any one person’s system. These are things like diet, the rate of your metabolism, your medical history, your dosage, as well as your environment.
Does Viagra make you last longer? It’s unlikely that this medication will increase the amount of time you can have sex. This medication supports your body to work the way it normally would when aroused and to have an erection hard enough to have sex. Taking this medicine means you’ll be able to experience sexual arousal and orgasm the same way you would naturally. Viagra won’t make you last longer in bed or have more orgasms than your body can safely handle.
Sildenafil rapid-dissolve lozenges have gained much attention as an effective treatment for erectile dysfunction. These lozenges disintegrate and dissolve in the mouth or beneath the tongue within 15-20 minutes. PDE5 inhibitors like sildenafil, tadalafil, and vardenafil are first-line treatments for erectile dysfunction. PDE5 inhibitors work by inhibiting the breakdown of cyclic guanosine monophosphate (cGMP) in the smooth muscle of the penis. PDE5 inhibitors in the form of lozenges are not commercially available and can only be made by a compounding pharmacy.
Sildenafil Lozenges – Rapid Onset
Fast-acting sildenafil lozenges promote quick absorption and rapid onset. Sildenafil lozenges kick in faster than their tablet counterpart, in as little as 15 minutes. Since the lozenges are dissolved under the tongue they start working much faster than a tablet that has to pass through the digestive system. A sublingual dosage form is not as effected by food ingestion as the orally administered tablets.
Studies have shown that sublingual sildenafil is safe and effective. In one study, sixty‐five percent of patients (13/20) who received sublingual sildenafil achieved satisfying erections and coitus, whereas the rate was 15% in the placebo group (3/20). Minimal side effects were noticed and included headache, sweating, and flushing.
What special precautions should I follow?
Before taking sildenafil,
- tell your doctor and pharmacist if you are allergic to sildenafil, any other medications, or any of the ingredients in sildenafil products. Ask your pharmacist for a list of the ingredients.
- do not take sildenafil if you are taking or have recently taken riociguat (Adempas) or nitrates (medications for chest pain) such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Monoket), and nitroglycerin (Minitran, Nitro-Dur, Nitromist, Nitrostat, others). Nitrates come as tablets, sublingual (under the tongue) tablets, sprays, patches, pastes, and ointments. Ask your doctor if you are not sure whether any of your medications contain nitrates.
- do not take street drugs containing nitrates such as amyl nitrate and butyl nitrate (‘poppers’) while taking sildenafil.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), tamsulosin (Flomax, in Jalyn), and terazosin; amlodipine (Norvasc, in Amturnide, in Tekamlo); certain antifungals such as itraconazole (Onmel, Sporanox) and ketoconazole (Nizoral); anticoagulants (‘blood thinners’) such as warfarin (Coumadin, Jantoven); certain barbiturates such as butalbital (in Butapap, in Fioricet, in Fiorinal, others) and secobarbital (Seconal); beta blockers such as atenolol (Tenormin, in Tenoretic), labetalol (Trandate), metoprolol (Lopressor, Toprol XL, in Dutoprol), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal LA, InnoPran); bosentan (Tracleer); cimetidine ; efavirenz (Sustiva, in Atripla); erythromycin (E.E.S., E-Mycin, Erythrocin); HIV protease inhibitors including amprenavir (Agenerase; no longer available in the U.S.), atazanavir (Reyataz, in Evotaz), darunavir (Prezista, in Prezcobix), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir (in Kaletra), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), saquinavir (Invirase), and tipranavir (Aptivus); nevirapine (Viramune); other medications or devices to treat erectile dysfunction; medications for high blood pressure; certain medications for seizures including carbamazepine (Carbatrol, Epitol, Tegretol, others), phenobarbital, and phenytoin (Dilantin, Phenytek); rifabutin (Mycobutin); and rifampin (Rifadin, Rimactane, in Rifamate, in Rifater). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with sildenafil, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
- tell your doctor what herbal products you are taking or plan to take, especially St. John’s wort.
- tell your doctor if you smoke, if you have ever had an erection that lasted for several hours, and if you have recently lost a large amount of body fluids (dehydration). This can happen if you are sick with fever, diarrhea, or vomiting; sweat a lot; or do not drink enough liquids. Also tell your doctor if you have or have ever had pulmonary veno-occlusive disease (PVOD; blockage of veins in the lungs); a stomach ulcer; heart, kidney, or liver disease; a heart attack; an irregular heartbeat; a stroke; chest pain; high or low blood pressure; high cholesterol; a bleeding disorder; blood circulation problems;blood cell problems such as sickle cell anemia (a disease of the red blood cells), multiple myeloma (cancer of the plasma cells), or leukemia (cancer of the white blood cells); conditions affecting the shape of the penis (e.g., angulation, cavernosal fibrosis, or Peyronie’s disease); or diabetes. Also tell your doctor if you or any of your family members have or have ever had an eye disease such as retinitis pigmentosa (an inherited eye condition that causes loss of vision) or if you have ever had sudden severe vision loss, especially if you were told that the vision loss was caused by a blockage of blood flow to the nerves that help you see.
- if you are a woman and you are taking sildenafil to treat PAH, tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking sildenafil, call your doctor.
- if you are having surgery, including dental surgery, tell your doctor or dentist that you are taking sildenafil.
- if you are taking sildenafil to treat erectile dysfunction, tell your doctor if you have ever been advised by a healthcare professional to avoid sexual activity for medical reasons or if you have ever experienced chest pain during sexual activity. Sexual activity may be a strain on your heart, especially if you have heart disease. If you experience chest pain, dizziness, or nausea during sexual activity, call your doctor immediately and avoid sexual activity until your doctor tells you otherwise.
- tell all your healthcare providers that you are taking sildenafil. If you ever need emergency medical treatment for a heart problem, the healthcare providers who treat you will need to know when you last took sildenafil.
What special dietary instructions should I follow?
Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medicine.
What should I do if I forget a dose?
If you are taking sildenafil for erectile dysfunction, you are unlikely to miss a dose since this medication is taken as needed, not on a regular dosing schedule.
If you are taking sildenafil for PAH, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What side effects can Viagra cause?
Sildenafil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- flushing (feeling of warmth)
- difficulty falling asleep or staying asleep
- numbness, burning, or tingling in the arms, hands, feet, or legs
- muscle aches
- changes in color vision (seeing a blue tinge on objects or having difficulty telling the difference between blue and green)
- sensitivity to light
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:
- sudden severe loss of vision (see below for more information)
- blurred vision
- sudden decrease or loss of hearing
- ringing in ears
- dizziness or lightheadedness
- chest pain
- worsening shortness of breath
- erection that is painful or lasts longer than 4 hours
- itching or burning during urination
Some patients experienced a sudden loss of some or all of their vision after they took sildenafil or other medications that are similar to sildenafil. The vision loss was permanent in some cases. It is not known if the vision loss was caused by the medication. If you experience a sudden loss of vision while you are taking sildenafil, call your doctor immediately. Do not take any more doses of sildenafil or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor.
There have been reports of heart attack, stroke, irregular heartbeat, bleeding in the brain or lungs, high blood pressure, and sudden death in men who took sildenafil for erectile dysfunction. Most, but not all, of these people had heart problems before taking sildenafil. It is not known whether these events were caused by sildenafil, sexual activity, heart disease, or a combination of these and other causes.Talk to your doctor about the risks of taking sildenafil.
Some patients experienced a sudden decrease or loss of hearing after they took sildenafil or other medications that are similar to sildenafil. The hearing loss usually involved only one ear and did not always improve when the medication was stopped. It is not known if the hearing loss was caused by the medication. If you experience a sudden loss of hearing, sometimes with ringing in the ears or dizziness, while you are taking sildenafil, call your doctor immediately. If you are taking sildenafil (Viagra) for erectile dysfunction, do not take any more doses of sildenafil (Viagra) or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor. If you are taking sildenafil (Revatio) for PAH, do not stop taking your medication until you talk to your doctor.
Sildenafil may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
What should I know about storage and disposal of this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store the tablets at room temperature and away from excess heat and moisture (not in the bathroom). Store the suspension at room temperature or in a refrigerator, but do not freeze it. Dispose of any unused suspension after 60 days.
It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.
In case of emergency/overdose
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.
What other information should I know?
Keep all appointments with your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Last Revised – 01/15/2018
Is it safe to buy Viagra online?
We’re so glad you asked! Because Viagra is one of the most widely counterfeited ED meds, you need to be really careful about where you get it online. Please consult with your doctor or nurse practitioner before taking anything marketed as an herbal supplement for erectile dysfunction since these aren’t FDA-approved treatments. Plus, many of these supplements have been shown to contain dangerous and harmful ingredients.
Another danger is buying something marketed as Viagra online that is actually a counterfeit drug. Pfizer has some helpful tips to make sure that the ED meds you’re getting aren’t counterfeit.
You should always:
- buy from a licensed online pharmacy with a US mailing address
- buy from a pharmacy that requires a prescription
- take only FDA-approved meds
- work with a licensed doctor or nurse practitioner and pharmacist
- ensure you can contact your provider for questions or other help