The History and Development of Sildenafil
Yet myth-based questions continue to follow the little blue pill around. Can Viagra give you a never-ending erection?
- Viagra should be taken approximately one hour before sexual activity.
- It may interact with medications for blood pressure and prostate issues.
- Alcohol consumption can reduce the effectiveness of Viagra.
- Patients should consult their doctor about their health history before use.
- Erectile dysfunction can be caused by health issues such as diabetes or obesity.
- Viagra is classified as a phosphodiesterase type 5 inhibitor.
- Its patent was initially held by Pfizer, leading to widespread popularity.
- Generic versions of sildenafil are available in many countries.
Let’s set the record straight with the help of urologist Drogo Montague, MD. Odds are you’ve seen a Viagra commercial and heard this warning: Seek immediate medical help for an erection lasting four or more hours. It’s an attention-grabbing piece of cautionary advice. But the situation that it addresses — a condition known as priapism — is a relatively uncommon side effect of the medication, says Dr. Montague. A study published in 2020 categorized long-lasting erections from Viagra and other ED medications as a “rare event.” Researchers found 411 cases of drug-induced priapism while reviewing more than two decades worth of data. But your odds of problematic prolonged erections increase if you combine Viagra with certain penile injection therapies, notes Dr. Montague. “Combining the treatments has a cumulative effect — penile injection therapy makes your erections hard, and adding Viagra makes them harder and even more long-lasting,” he continues. “So stay on the safe side and don’t pair them.” Here’s a fun fact for you: Viagra was created to help your heart.
4. Effects of Viagra on various organ systems in the Body
Sexual activity is not a major contributor to the risk of a heart attack. Sexual activity, with or without sildenafil (Viagra) increases the chance of an MI during sexual activity by only 0.1%. If pills fail, there are vacuum devices, Muse, injections, bypass surgery and implants. The patient making a presentation has had penile bypass surgery. In addition he takes testosterone and sildenafil as needed.
Pharmacological Class
This is a classic example of why people with ED need complete care: a psychological exam, history and physical exam, and diagnostic studies with long term follow-up care. Patients with ED should not just be prescribed sildenafil (Viagra) and then be lost to follow-up. Don’t believe everything you’ve heard about ‘the little blue pill’ Image content: This image is available to view online. Physician's hand holding a blue pill in the palm of his hand, offering it to a patient. Those four words are all that’s required to identify Viagra®, the brand name for a medication used to treat erectile dysfunction (ED).
Natural and over-the-counter alternatives for ED
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. The medication, officially known as sildenafil, debuted in 1998. Today, it’s used by millions of men around the world when they want to … well, rise to the occasion during an amorous moment. Researchers initially developed Viagra to treat angina, a type of chest pain. Angina occurs when your heart doesn’t get enough oxygen-rich blood and starts working harder to compensate. Now, Viagra didn’t exactly shine as a treatment for angina … but the stiffer erections the little blue pill caused certainly stood out as a side benefit. Which brings us back to the question regarding Viagra and your heart.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Viagra Generic | 50mg | 60 + 4 Pills | 83.93€ 79.93€ | |
| Viagra Original | 100mg | 92 + 4 Pills | 362.88€ 345.60€ | |
| Viagra Generic | 25mg | 30 + 4 Pills | 47.97€ 45.69€ | |
| Viagra Professional | 100mg | 120 + 4 Pills | 262.83€ 250.31€ | |
| Viagra Professional | 100mg | 20 Pills | 71.14€ 67.75€ | |
| Viagra Super Active | 100mg | 60 + 8 Pills | 116.84€ 111.28€ | |
| Viagra Generic | 100mg | 360 + 10 Pills | 330.21€ 314.49€ | |
| Viagra Professional | 100mg | 10 Pills | 44.09€ 41.99€ | |
| Viagra Generic | 200mg | 270 + 10 Pills | 379.76€ 361.68€ | |
| Viagra Generic | 25mg | 180 + 6 Pills | 154.93€ 147.55€ | |
| Viagra Oral Jelly | 100mg | 21 Sachets | 78.66€ 74.91€ | |
| Viagra Generic | 150mg | 90 + 6 Pills | 147.18€ 140.17€ | |
| Viagra Professional | 100mg | 30 Pills | 88.92€ 84.69€ | |
| Viagra Soft Tabs | 100mg | 120 + 8 Pills | 232.21€ 221.15€ | |
| Viagra Generic | 50mg | 120 + 6 Pills | 129.64€ 123.47€ |
The erectile dysfunction medication isn’t harmful to your ticker when taken on its own.
Viagra Contraindications
Structurally vardenafil (Levitra) is similar to sildenafil, while tadalafil (Cialis) is very different. Vardenafil (Levitra) is almost 10 times more biochemically potent than sildenafil, therefore a lower dose is needed to facilitate the penile erection, potentially resulting in less side effects. Selectivity is the ability of the drug to attach to the specific enzyme PDE 5 found in penile tissues. Vardenafil (Levitra) is more selective than sildenafil and tadalafil (Cialis) to PDE5, which again means a lower dose is needed with potentially less side effects. Tadalafil is very specific for PDE5 and is also very specific for the enzyme PDE11.
Possible Side Effects of Sildenafil
Unfortunately, we don’t know much about PDE11, which is found in the heart, in the pituitary gland in the brain and in the testicles. Pharmacokinetics, half-life, is how long the medication stay s in the blood. This means that vardenafil (Levitra) should act longer than sildenafil (Viagra) but the clinical significance is not known. Tadalafil (Cialis) has the longest half-life and allows you to take the medication and not relate the sexual activity to the immediate use of the medication. The drawback is if you need nitrates after using tadalafil (Cialis), this medication lasts a long time in your blood stream and yellow viagra pill may place you at a higher risk.
What to do in case you take too much Viagra
Younger people might do well treated with tadalafil, (Cialis) while older people with other health issues might be better off using sildenafil (Viagra) or vardenafil (Levitra) but more data are needed. The side effects of vardenafil (Levitra) are potentially less than sildenafil (Viagra), but more data are needed. In a recent study on men with erectile dysfunction and diabetes, vardenafil (Levitra) improved their erectile dysfunction. Tadalafil (Cialis) is as effective as sildenafil (Viagra), and vardenafil (Levitra) with similar side effects except for back pain that occurs occasionally with tadalafil, probably because of the long half-life. Many people stop taking drugs because they are experiencing side effects, they no longer have a partner, or they are worried about safety. That’s an important caveat because Viagra should NOT be taken with heart medications that include nitrates. Like nitrates, Viagra helps dilate (or expand) blood vessels constricted by coronary artery disease.
| Property | Description | Units / Format | Notes |
|---|---|---|---|
| Active Ingredient | Sildenafil Citrate | mg | 50 mg, 100 mg |
| Brand Names | Viagra, Revatio, Sildenafil | N/A | Variations depending on use |
| Typical Dosage | 50-100 mg | mg | Taken as needed before sexual activity |
| Onset of Action | 30-60 minutes | minutes | Time to start feeling effects |
| Duration of Effect | Up to 4-6 hours | hours | Effect duration |
Your blood pressure drops when this happens, as less force is needed to pump blood through your system.
| Parameter | Value | Notes |
|---|---|---|
| Absorption Time | 30-60 minutes | Peak plasma concentrations |
| Bioavailability | ~40% | Due to first-pass metabolism |
| Half-life | 4-5 hours | Time for plasma concentration to reduce by half |
| Metabolism | Liver (CYP3A4 enzyme) | Mainly processed in the liver |
| Excretion | Feces and urine | About 80% in feces, 13% in urine |
The worry if you take both Viagra and nitrates is that your blood pressure could drop too low, a condition known as hypotension. Abnormally low blood pressure increases your risk of a heart attack or stroke. Talk to your healthcare provider before taking Viagra with other medications. Taking Viagra to enhance your bedroom performance likely won’t make it more difficult for you to see your partner — unless you overdo it.
| Condition / Situation | Reason | Recommendation |
|---|---|---|
| Use with Nitrates | Risk of severe hypotension | Avoid concomitant use |
| Cardiovascular conditions | Increased heart attack risk | Consult doctor before use |
| Recent stroke or unstable angina | Potential for worsening condition | Avoid until stabilized |
| Liver or kidney impairment | Altered drug metabolism | Dose adjustment necessary |
| Allergies to sildenafil or excipients | Risk of allergic reactions | Check ingredients carefully |
High doses of Viagra have been connected to temporary vision issues, reports the American Academy of Ophthalmology. But overall, the medication is considered low risk when it comes to eyesight.
Chemical synthesis
Little attention has been paid to endocrine factors. Testosterone modulates desire, arousal and orgasmic function. Concerning the orgasmic response, testosterone modulates the integrity of genital sensory receptors. Concerning the arousal response, decreased testosterone blood levels can influence the efficacy of sildenafil (Viagra). If the sildenafil response is not reliably improving erection, the physician should first check if the patient is taking the pill correctly.
Can sildenafil citrate cause erectile dysfunction?
The physician should also check the patient’s testosterone level. One investigator in Italy gave testosterone to patients with low testosterone who did not respond to sildenafil (Viagra). When daily testosterone was given, subsequent sildenafil (Viagra) use resulted in IIEF (the International Index of Erectile Function questionnaire used to determine erectile function) scores improving significantly. Other risk factors for erectile dysfunction include neurologic problems (multiple sclerosis, stroke), depression and medications for treating diabetes, hypertension, heart disease and depression. There are many oral therapies for erectile dysfunction, but the only approved medication in the US is the PDE 5 enzyme inhibitor sildenafil (Viagra).
Does Viagra increase the size of a man’s penis?
Unapproved therapies, some of which are available in the US and some elsewhere, some of which have data to prove efficacy and some not, include tadalafil (Cialis), vardenafil (Levitra), yohimbine, phentolamine, trazodone, apomorphine and neutraceuticals. PDE5 inhibitors act to relax penile erectile tissues with sexual stimulation thus enhancing your ability to get an erection. Sildenafil (Viagra) is effective for all sorts of erectile dysfunction in 69% of people. Why is there a need for another pill? In some cases the erection is not hard enough, sometimes sildenafil (Viagra) just doesn’t work. There’s a slight chance, though, that the pill may color your world blue for a bit.
- Viagra’s popularity led to increased research for similar ED drugs.
- It is not recommended for use by women or children.
- Some users report prolonged erections, which require medical attention.
- Viagra does not cure erectile dysfunction; it helps manage symptoms.
- Safety and efficacy are best evaluated with medical advice.
- The medication can cause visual disturbances in some users.
- Viagra is sometimes used recreationally, which is risky.
- Proper dosage and timing are essential for safety and effectiveness.
Chemicals in Viagra can temporarily change how light hits your eyes, giving everything you see a short-lived blue tint. This reaction is more likely if you take a maximum dose of Viagra (100 milligrams).
Vision Problems
They seem to affect certain pathways in the brain that influence sexual desire. Side effects of Addyi include low blood pressure, fainting, and nausea. These effects may be more intense if you take birth control pills or drink alcohol. Side effects of Vyleesi include a temporary increase in blood pressure and a decrease in heart rate. It can also cause nausea and isolated spots of skin lightening (focal hyperpigmentation).
Treatment & Diagnosis
Viagra is FDA approved to treat erectile dysfunction. It doesn’t have approval for treating female sexual dysfunction, and studies thus far have had mixed results. There’s no “female Viagra,” but there are a couple of drugs with approval to treat sexual dysfunction associated with specific conditions. There are many reasons for low sex drive. Before taking Viagra or any other medication, talk with your doctor about the potential benefits, risks, and side effects of these medications for you.
What causes an erection?
The most common sexual dysfunctions in men include lack of interest, premature ejaculation and erectile dysfunction. The latter affects 52% of men between the ages of 40 and 70, including mild, moderate and complete forms of ED. Organic or physical causes for sexual dysfunction in men include vascular, hormonal and neurologic factors. Concerning vascular causes, the risk factors for atherosclerosis (including smoking, high blood pressure, diabetes (diabetics do not respond well to pills like sildenafil (Viagra)) and high cholesterol are ALSO risk factors for erectile dysfunction. Since a straddle injury or use of a narrow saddle can obstruct and impair arteries to the penis, bicycle riding is also considered a risk factor for erectile dysfunction. “This side effect can happen with higher doses, but it’s uncommon,” says Dr. Montague. Viagra increases blood flow to your penis, which can help you get and maintain an erection for whatever activity you have in mind.