
Priapism is considered a medical emergency, so seek medical attention as soon as you can to avoid damaging the erectile tissue inside your penis. With that said, be cautious when taking sildenafil if you have Peyronie’s disease (scar tissue in the penis) or another deformation of the penis that may increase your risk of priapism.
Sildenafil and other PDE5 inhibitor medications can interact with other drugs. In particular, sildenafil is known to interact with: Ritonavir and other CYP3A4 inhibitors, such as the antifungals ketoconazole, itraconazole, and erythromycin Ritonavir and other CYP3A4 inhibitors, such as the antifungals ketoconazole, itraconazole, and erythromycin As such, you shouldn’t take sildenafil or brand-name Viagra if you use nitroglycerin or similar prescription organic nitrates.
A healthcare professional might also consider how often you have sex. Your dosage may be adjusted if you have sex frequently and take sildenafil very often — or if you only take this medication once every few days for less frequent sexual intercourse. Sildenafil was originally developed to treat angina (chest pain) and hypertension (high blood pressure). In the early ‘90s, researchers discovered that it may make an effective treatment for erectile dysfunction. Along with ED, sildenafil has been used off-label as a treatment for: Raynaud’s phenomenon (decreased blood flow to the extremities, causing coldness and numbness) Raynaud’s phenomenon (decreased blood flow to the extremities, causing coldness and numbness) Altitude-induced hypoxemia (lack of sufficient oxygen in the blood in high altitudes) Altitude-induced hypoxemia (lack of sufficient oxygen in the blood in high altitudes) Off-label use is when a drug is prescribed by a licensed healthcare provider to treat something it’s not FDA-approved for — this is legal and common.
The dosages of sildenafil are typically different when treating these other health conditions. Learn more in our sildenafil dosages guide. Sildenafil works well for most men with erectile dysfunction at any dosage. However, the highest 100mg dosage produces improvements for a higher percentage of men than 50 or 25mg. The downside is that 100mg also generally causes more side effects.
If you have mild or moderate ED, your healthcare provider will likely prescribe 50mg of sildenafil as your starting dose. This is the typical go-to oral dose for sildenafil — for many men, it’s enough to treat erectile dysfunction and improve sexual performance. The 100mg dose of sildenafil is generally safe if that’s what your provider prescribed. In some cases, 100mg may be too much. And even those who start on the 50mg dose might go down to 25mg of sildenafil if they’re experiencing unmanageable side effects. You also shouldn’t mix sildenafil with recreational drugs called “poppers“ that contain nitrites.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Viagra Generic | 100mg | 360 + 10 Pills | 330.21€ 314.49€ | |
| Viagra Generic | 25mg | 30 + 4 Pills | 47.97€ 45.69€ | |
| Viagra Generic | 50mg | 20 Pills | 40.52€ 38.59€ | |
| Kamagra Soft Tabs | 100mg | 180 + 8 Pills | 425.45€ 405.19€ | |
| Kamagra Polo | 100mg | 120 + 6 Pills | 327.15€ 311.57€ | |
| Viagra Generic | 150mg | 180 + 10 Pills | 236.46€ 225.20€ | |
| Kamagra Oral Jelly | 100mg | 30 + 5 Sachets | 136.20€ 129.71€ | |
| Viagra Generic | 200mg | 20 Pills | 61.69€ 58.75€ | |
| Kamagra Soft Tabs | 100mg | 60 + 4 Pills | 180.59€ 171.99€ | |
| Viagra Generic | 25mg | 60 + 4 Pills | 71.99€ 68.56€ | |
| Viagra Generic | 25mg | 90 + 6 Pills | 105.03€ 100.03€ | |
| Kamagra Polo | 100mg | 180 + 8 Pills | 446.52€ 425.26€ | |
| Viagra Generic | 200mg | 180 + 10 Pills | 277.56€ 264.34€ | |
| Kamagra | 100mg | 120 + 6 Pills | 330.74€ 314.99€ | |
| Viagra Generic | 25mg | 180 + 6 Pills | 154.93€ 147.55€ | |
| Viagra Generic | 150mg | 60 + 4 Pills | 111.25€ 105.95€ | |
| Viagra Generic | 150mg | 270 + 10 Pills | 326.61€ 311.06€ |
Weirdly, grapefruit juice can change the concentrations of PDE5 inhibitors in your body, so you’ll want to avoid it while taking sildenafil. Learn more about sildenafil drug interactions in our guide. It’s best to seek medical advice from a healthcare professional about any medications or supplements you currently take or have recently taken before starting sildenafil. Also, be sure to mention any underlying medical conditions you have, including: Heart problems like pulmonary arterial hypertension, angina, or an irregular heartbeat Heart problems like pulmonary arterial hypertension, angina, or an irregular heartbeat A blood disease like leukemia or sickle cell anemia A blood disease like leukemia or sickle cell anemia The more you tell your healthcare provider, the better they’ll be able to assess your personal risk of side effects and make sure you’re safe while using sildenafil. Sildenafil comes in several dosages, but for ED, it ranges from 25 to 100mg. Your healthcare provider may prescribe sildenafil at a dosage of 100mg if you have moderate to severe erectile dysfunction or if you don’t experience any improvements at a lower dosage.
Here’s what to keep in mind: Sildenafil might be a more effective ED treatment at higher dosages, but it could also cause more side effects.
| Condition | Explanation |
|---|---|
| Nitrate Use | Avoid due to risk of severe hypotension |
| Heart Conditions | Caution in unstable angina or recent MI |
| Retinal Disorders | Caution, especially in hereditary degenerations |
| Allergies | Do not use if allergic to sildenafil or related drugs |
Sildenafil might be a more effective ED treatment at higher dosages, but it could also cause more side effects.
In clinical trials, researchers found that 82 percent of men with ED reported some improvements in erectile function after using sildenafil at a dosage of 100mg. In the same trials, 74 percent and 63 percent of men reported improvements with 50mg and 25mg of sildenafil, respectively. Other clinical trials have suggested that doses above 100mg don’t improve the effectiveness of the medication but do increase side effects. Sildenafil at any dosage takes roughly 30 sildenafil pfizer 100g to 60 minutes to start working, so you should try to take it an hour or so before sexual activity. That might mean slipping away into the bathroom after you’ve paid the bill or being sneaky on your way back to the car.
The point is, you don’t want to take sildenafil 10 minutes before your clothes come off — it needs a little more time to do its thing in your system. Once you take the pill, sildenafil can be effective for 30 minutes to four hours, so you have a little wiggle room for planned sexual activity. But, any longer than four hours, and the concentration in your blood might be too low to have a significant effect on your erection quality. These medications work by inhibiting the PDE5 enzyme, allowing blood vessels in the penis to relax and increasing blood flow to the area. One critical feature of PDE5 inhibitors is that they only cause erections when you’re feeling in the mood for sex — that is, sexually stimulated physically or mentally.
Contrary to popular belief, they won’t cause spontaneous erections (assuming you aren’t thinking about something sexual) or affect your sex drive in any significant way. This means that if you aren’t sexually aroused, sildenafil won’t kick in at all. One of the biggest advantages of sildenafil is that it’s an easy medication to use. For the most part, sildenafil can be taken before you plan to have sex without any major concerns. Having said that, there are a few things you can do to get the best results from it: Take sildenafil 100mg around one hour before sex. Let your healthcare provider know if you experience any issues while using sildenafil to treat ED, including side effects or drug interactions.
| User Comment | Experience Summary |
|---|---|
| "Works quickly" | Positive, effective in 30 minutes |
| "Some side effects" | Headache and flushing experienced |
| "Effective for ED" | Successful in achieving erection |
| "Need higher dose" | Some users reported inadequate effects |
| "No issues" | No side effects, good overall satisfaction |
If you do experience adverse effects with sildenafil that outweigh the benefits of taking it, you may benefit from trying another PDE5 inhibitor, such as Stendra® (avanafil), tadalafil (Cialis®), or vardenafil (previously sold as Levitra®).
| Drug Class | Interaction Effect |
|---|---|
| Nitrates | Severe hypotension |
| Alpha-blockers | Increased risk of hypotension |
| CYP3A4 inhibitors | Increased sildenafil levels, risk of side effects |
| Other PDE5 inhibitors | Increased risk of adverse effects |
We offer sildenafil and several other ED medications online, following an online ED consultation with a licensed healthcare provider who’ll determine if a prescription is appropriate.
Like most medications, side effects are generally more likely at higher doses than lower doses. For instance, in clinical trials of sildenafil, 16 percent of men reported headaches (the most common side effect) at a dosage of 25mg, compared to 28 percent at 100mg and seven percent who took a placebo. Vision changes (blurred vision or changes in color perception) Vision changes (blurred vision or changes in color perception) Our blog goes over all the possible sildenafil side effects in more detail. Although rare, sildenafil can cause more serious side effects that may need immediate medical attention. Eye problems like blurred vision or sudden, severe loss of vision Eye problems like blurred vision or sudden, severe loss of vision Serious cardiovascular disease — often in people with preexisting risk factors, such as stroke, ventricular arrhythmia (abnormal heartbeat), or heart attack Serious cardiovascular disease — often in people with preexisting risk factors, such as stroke, ventricular arrhythmia (abnormal heartbeat), or heart attack In very rare cases, sildenafil may also cause priapism — a prolonged and painful erection that may last four hours or longer. Interested in finding out more before you get started? Our guide to the most common treatments for erectile dysfunction goes into detail about the most effective options, from sildenafil to other FDA-approved medications. Sildenafil: from angina to erectile dysfunction to pulmonary hypertension and beyond. A systematic review of sildenafil mortality through the years.
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Sildenafil usually takes about a half-hour to start working. But for optimal results, take your prescribed dose of sildenafil an hour before you plan to have sex in case you metabolize the medication a little slower. Take sildenafil 100mg around one hour before sex. Avoid high-fat meals while using sildenafil. Eating a meal high in fat may slow down your body’s absorption of sildenafil and delay its effects.
Try to eat a normal meal with a low-to-moderate fat content to ensure sildenafil works as expected. Don’t panic if sildenafil isn’t effective the first time. A variety of factors can play a role in ED, and sexual performance anxiety is one of them. If you notice sildenafil doesn’t work after a few tries, tell your healthcare provider. They may recommend changing your dose, switching medications, or trying other treatments.
Simple habits — such as exercising often, eating a balanced diet, and limiting alcohol intake — can all have a positive effect on erections and sexual performance. Our guide to maintaining an erection naturally shares techniques to reduce your risk of ED and enjoy better sex. Learn more about how to take sildenafil in our guide. Most side effects of sildenafil are mild, and it’s uncommon for them to persist longer than the medication is active in your body. However, in rare cases, sildenafil sildenafil citrate drug treatment can cause more severe or bothersome side effects. Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations.