Viagra/Sildenafil - Everything You Need to Know
Sildenafil in its most popular branded version, Viagra - has revolutionised the treatment of erectile dysfunction or ED. The little blue pill is recognised throughout the world. This is no accident.
The medication is a remarkably effective treatment of a commonly experienced symptom. Couple this with the fact that it can be taken when and where it is needed, and is relatively free from side effects, it is not surprising the medication has many fans.
Of course, it is not for every man. For some men it is not suitable. But for most men it works and provides considerable relief.
With Viagra's patent having expired, generic drugs containing sildenafil is now available at a fraction of the cost.
Regulated services supplying sildenafil
Online clinics mentioned below are registered with the CQC, employ GMC doctors and post medicine from GPhC registered pharmacies.
What makes it a special drug?
The best drugs are ones which are highly specific. They target problems and have few side effects. They work in the body only where they are needed. Sildenafil is a classic example of a drug like this.
During sexual arousal the blood flow to the penis increases to cause stiffening. Sildenafil citrate (active ingredient) affects one of the steps along the path to increased blood flow. It multiplies the natural effect of arousal. If there is no arousal there is no erection. This is just right for an ED drug.
The famous blue pill is specifically an enzyme inhibitor. It inhibits phosphodiesterase which is a PDE5 inhibitor.
Why do some men need it?
Many men have reduced erections, particularly when they get over the age of 40, but often before. Reduced strength of erections is natural and normal, but often unwelcome. Most men who are troubled by erectile dysfunction are in generally reasonable health.
In some men with erectile dysfunction, circulation may be impaired. There may be raised blood pressure or raised cholesterol. Some men get anxious in situations of arousal and this may interfere with their erections.
Whatever the cause Viagra or one of the other PDE5 drugs, such as Cialis or Levitra, will usually help.
How to buy Viagra/sildenafil?
Most men who benefit from this medication need to buy it privately for themselves. It is not usually free on the NHS to most men. In the UK most men who buy the medication, get it online. There are half a dozen or so reputable UK online clinics supplying it.
They all employ doctors to issue prescriptions after online consultations. You need to keep in mind that these clinics all provide similar services and identical drugs. The medication is issued on prescription from registered pharmacies and posted from the UK.
Once you have found one of these clinics, there is really no point in spending any more than you have to. The drugs supplied are identical.To help choose we have compared some clinic prices (above) in order of price.
Real or Fake
Genuine sildenafil is produced by various UK drug companies. Pfizer's exclusive patent in the UK expired in June 2013. Prescription medicines should be obtained only from regulated sources - see regulation page.
What are its advantages over other ED drugs?
One thing many men like about Sildenafil is the confidence it provides them. The drug is well known and has been around longer than other ED drugs. Many men know that after a tablet of the right strength they will be able get a good erection about 30 to 60 minutes later.
They know that the effect will last around 4 hours, after which the drug will no longer be active. It is not addictive or harmful. The side effects are usually minimal and there is no hang over effect.
Other erectile dysfunction drugs, in truth, are also generally very effective. They tend to be less well known and have less well recognised names. These other ED drugs tend to work for longer. This longer duration of action can be an advantage, although many men do not like unwanted erections long after they have taken their tablets.
Does it help every man with impotence?
Men with impotence should tell their regular doctors about it for investigations and advice.
Sildenafil will help the majority of cases. It can even break a cycle of performance anxiety. Men who were once worried about their performance can sometimes use it for a while until their confidence returns. They may never need to take it again after using it for a while.
Some men's erectile problem is caused by operations and spinal disease or injury. The arousal signals do not get from the brain to the penis. Viagra will usually help in this situation, but if the mechanism by which erections occur is not working at all, then other treatments such as stiffening devices or injections into the penis may be a better option.
Starting the medication for the first time?
As a first time user, finding the right dose is important. Most men start with the medium strength tablet of 50mg. If this strength is highly effective, subsequent doses of 25mg can be tried. If it is not strong enough, the dose can be increased to 100mg. Only change strength after trying a tablet a few times.
It is possible, particularly in men prone to low blood pressure, for a first dose to cause light headedness and even fainting. For this reason, it is best to take the first dose in situations where it is possible to lie down or sit down in the first few hours after the tablet.
Men should only take sildenafil in situations where they expect to have arousal and erections in the following few hours. No harm will come from taking a tablet and not needing it, however there is no benefit in taking it in this situation.
The dose can be repeated, but no more than one tablet should usually be taken in a 24 hour period. Daily use is not recommended. If the tablet is required on a daily basis, it is probably best to switch to a longer acting ED drug such as Cialis or Levitra.
Once a man finds a dose which is effective and without side effects, the same dose should be used each time. The body does not normally tend to become used to the drug or immune to its effects.
Are there limitations on its use?
Doctors get concerned if young men take Viagra even when they do not really need it. Recreational use of the drug a is not always a risk but it should not be encouraged. Very occasionally, if it is taken by young men, sometimes in combination with recreational drugs, it can cause the serious medical condition of priapism.
Priapism is the medical word which describes prolonged painful erections. In extreme cases of erections lasting many hours, this can lead to serious and permanent damage to the penis. It is rare, but worth thinking about.
One must also avoid the use of this drug to give a lift to performance after drinking. Men take risks when they drink and increasing their capacity to have intercourse in this situation just adds to the risks.
Having said this, most men take the drug because they need it; they take it because it helps them and they use it with care as they would any other drug.
Who should not take it?
A good online clinic will check to see if sildenafil is suitable. Men taking some regular medications, particularly drugs called nitrates, should not take this medication.
Men with high or low blood pressure or men who are prone to fainting or dizziness should not take it.
The list of contraindications include:
- Allergies to previous erectile dysfunction treatments
- Angina and heart diseases
- History of Transient ischaemic attacks and strokes
- Circulation related vision problems
- Degenerative eye diseases like Retinitis pigmentosa
- Serious kidney/renal or liver disease
- Peyronie's disease - a condition where there is a deformity in the penis
- Leukaemia, Sickle cell disease or multiple myeloma
- Haemophilia - A bleeding disorder
- Gastric ulcers or peptic ulcers
Sildenafil 'generic Viagra'
The patent for Viagra expired 21 June 2013 in several European countries meaning that generic sildenafil is now available from many drug manufacturers including Teva, Actavis, Accord, Mylan, Sandoz and others.
Generic Viagra(Sildenafil) is medically identical, works in exactly the same way and is usually much lower cost (see the price comparison tab above).