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Sildenafil usually starts to work within 30 to 60 minutes.

It's triggered by sexual stimulation, so you need to be aroused for it to work. You should be able to get an erection at any time between 1 and 4 hours after taking sildenafil. Your erection should go away after you have had sex.

If you're taking sildenafil for erectile dysfunction, do not take it more than once a day. If you're taking sildenafil (Revatio) for pulmonary hypertension, do not take it more than 3 times a day.

There do not seem to be any lasting harmful effects from taking it for many months and years.

If sildenafil does not work, there are other tablets you could try that work in a similar way, such as: tadalafil (Cialis) - can be taken up to 36 hours before sex avanafil (Spedra) - can be taken up to around 4 hours before sex vardenafil (Levitra) - can be taken up to around 4 hours before sex.

This is a man-made hormone that helps to stimulate blood flow to the penis. Alprostadil comes as: an injection directly into your penis a small pellet placed inside your urethra (the tube that carries urine from your bladder to the tip of your penis) If you cannot get erections because of a hormonal problem, your GP may refer you to an endocrinologist (who specialises in the treatment of hormonal problems).

You may benefit from treatment using injections of man-made hormones to restore your hormone levels to normal. Other treatments for erectile dysfunction include: a vacuum pump psychological treatments penile implants pelvic floor muscle exercises.

Some complementary therapies, such as acupuncture, have claimed to treat erectile dysfunction. There are lots of treatments that claim to be a "herbal Viagra". A herbal Viagra has never been approved as a treatment for erectile dysfunction. Women can use sildenafil for pulmonary hypertension. There's no good evidence that sildenafil works for women with sexual problems. There's no firm evidence to suggest that taking sildenafil will reduce fertility in either women or men.

But speak to a pharmacist or your doctor before taking it if you're trying to get pregnant. Sildenafil does not affect any type of contraception, including the contraceptive pill and emergency contraception. A beer or a couple of glasses of wine are not likely to stop or delay sildenafil working. But drinking lots of alcohol can make it more difficult to get an erection. To get the most benefit from sildenafil, do not drink heavily before taking it.

Taking poppers (amyl nitrite) with sildenafil can have a dangerous effect on your heart.

It can also be potentially dangerous to take sildenafil with: stimulants like MDMA (ecstasy) or cocaine hallucinogens like LSD novel psychoactive substances (which used to be known as legal highs) like mephedrone. Sildenafil has not been properly tested with recreational drugs. Talk to your doctor if you think you might use any recreational drugs with sildenafil.

Do not drink grapefruit juice if you're taking sildenafil (Revatio) for pulmonary hypertension. You can eat and drink normally while taking sildenafil (Viagra) to get an erection.

Erectile dysfunction can often be improved if you make changes to your lifestyle, such as: Related conditions.

Ejaculation problems Erectile dysfunction (impotence) Male sexual problems Priapism (painful erections) Pulmonary hypertension.

Relate (sex therapy): charity Sexual Advice Association: charity Sildenafil: forum Viagra: forum.

Page last reviewed: 22 January 2019 Next review due: 22 January 2022.

Posted on 16 May 2016 24 October 2019 by Dr Tony Steele - Dr Fox is a CQC , GPhC , & MHRA regulated service.

Both Viagra and sildenafil are widely used to treat erectile dysfunction. Viagra is a brand name for the sildenafil produced and sold by the company Pfizer.

Sildenafil is also sold as a generic drug, which is medically identical to Viagra. Sildenafil citrate was created in 1989 by British scientists Albert Wood and Peter Dunn as a possible treatment for hypertension and angina; conditions associated with coronary heart disease. Nicholas Terrett, now often referred to as the father of Viagra, was named in the British patent for the drug as a heart medication.

And though Pfizer’s early trials of the drug in the 1990s did not prove its efficacy as a heart medication, patients who took part in the clinical trials reported increased erections after taking sildenafil.

Separate studies provided more information on the biochemical process that causes erections, which helped scientists understand how sildenafil could enhance the effects of sexual stimulation and open up blood vessels in the penis.

Sildenafil was then studied in men with erectile dysfunction, and in 1998 it was approved by the FDA specifically for treatment of ED.

When Pfizer lost its UK patent for the drug in June 2013 it made way for generic manufacturers to produce sildenafil, or ‘generic Viagra’. It costs a fraction of the price of Viagra, and has made the treatment more accessible to a wider range of patients.

You can now choose to buy Viagra, Pfizer’s branded drug, or sildenafil, the generic version. Branded Viagra comes in small diamond-shaped blue pills – Pfizer has also patented this pill design and appearance. Sildenafil is sold as white or blue tablets, with different characteristics depending on the brand. Some have chalky finishes while others are smooth, and some are scored for easy division, while others are not. Both Viagra and the different brands of sildenafil can be purchased in 25mg, 50mg, and 100mg preparations, and there is no significant difference between them in terms of active ingredients. Sildenafil tablets can come in many shapes, colours, and sizes – see comparing brands of sildenafil.

As a generic medicine, sildenafil is produced by a number of manufacturers, and competition among them helps to regulate its price and keep it affordable for consumers. Branded Viagra is only produced by Pfizer, whose name recognition and customer loyalty allow it to charge a higher price for its renowned ‘little blue pills’.

It is a requirement for the generic version to contain the same levels of the active ingredient in the body as its branded alternative, which is known as bioequivalence. Before generic drugs are licensed for sale the manufacturer must demonstrate bioequivalence to the licensing authorities (the European Medicines Agency).

If you have a private prescription for Viagra, the branded drug must be dispensed; but you may ask for sildenafil at the time that the prescription is made.

They are considered equally effective, however patients must follow proper protocol for optimum results. Also note that if the condition does not respond to the initial dose of Viagra or generic sildenafil, a higher dose may be required (after several unsuccessful attempts). Packaging differences: Viagra 100mg tablets and Mylan sildenafil 100mg tablets. Although Viagra is the most well-known medication for erectile dysfunction, a number of alternative treatments have become available in recent years. Though many people would like to know which treatment is better, there really is no straightforward answer to that question.

Both treatments can help men achieve satisfying erections and beat their erectile dysfunction, but both also have differing characteristics which will suit different men in different ways. You should bear in mind that the effectiveness of the treatment varies from one man to another, depending on the cause of the erectile dysfunction, its severity and the amount of sexual stimulation the patient receives. Therefore until you try for yourself, you cannot be sure of the exact results you will achieve. They relax the smooth muscles in the blood vessels supplying the penis.

This relaxation increases blood flow to aid an erection. However Viagra and Cialis have different active ingredients. In Viagra the PDE-5 inhibitor is sildenafil, while in Cialis it is tadalafil .

Some men may react better to one active ingredient than the other.

However both sildenafil and tadalafil work via the same mechanism so you should never take the two drugs together. Nor should you take more than one Viagra or Cialis pill at any one time. Both drugs require a sexual stimulus in order to take effect.

Neither Viagra or Cialis will cause an erection on their own. Viagra was initially developed and tested in the UK to treat angina and was meant to relax the blood vessels that supply the heart. While the results for treating angina were disappointing, many participants reported developing erections after taking Viagra.

Further research showed that Viagra relaxed the blood vessels supplying the erectile tissues.

The medication was launched in 1998 by Pfizer, and approved by the European Medicines Agency and US Food and Drug Administration, as the first oral drug to treat erectile dysfunction. Following the launch of Viagra, Eli Lilly joined forces with the ICOS Corporation to develop a newer version of this erectile dysfunction treatment. This treatment, Taladalafil, was approved for sale in 2002 in Europe, then in the US the following year. You can take Cialis as little as 30 minutes before you plan to have sex; whereas Viagra must be taken at least one hour before sex. If you have a large meal shortly before taking a pill, it will slow down the rate at which Viagra takes effect.

In contrast, you can take Cialis before or after eating. With both treatments you should limit your alcohol intake to enjoy the greatest effects.

It is not unusual for a man not to respond to erectile dysfunction treatment the first time he takes it. Indeed it is recommended you try taking the tablet on up to eight occasions. Then if no results are forthcoming discuss with your doctor about switching to a different dose or form of treatment. The biggest difference between Viagra and Cialis is the amount of time their effects last. Viagra remains effective for 4 to 6 hours, which offers ample opportunity to have sex on multiple occasions if you wish. However Cialis typically allows you to achieve erections for up to 36 hours after taking a tablet. Although Cialis lasts for up to 36 hours, this does not mean you will have an erection throughout that time – it should only happen when you are sexually stimulated. Cialis has comfortably the longest effectiveness period of any erectile dysfunction drug on the market.

Side effects for either drug are rare but not unheard of.

As Cialis and Viagra are both PDE-5 inhibitors, they have similar side effects; although you may find that because Cialis is effective for longer, any side effects you experience may also last for longer. The most likely unwanted effects are light-headedness, headaches or flushing to the face.

Nasal congestion, indigestion and visual changes are sometimes experienced as well.

If you experience chest pain or a prolonged erection for more than four hours, you must seek urgent medical help. Both Viagra and Cialis are prescription drugs so you must consult with a doctor before you can take them. Cost is another notable distinction between Viagra and Cialis.

The longer effectiveness of Cialis is reflected in its price. While Cialis is slightly more expensive than Viagra, many men will consider the vastly greater duration period of Cialis to represent good value for money.

Equally, plenty of men will prefer the cheaper price and renowned brand name offered by Viagra. But ultimately it depends entirely on the individual.

Sildenafil and Tadalafil are the most well-known of all the ED medications.

They are both in a class of medications called ‘phosphodiesterase type 5 (PDE5) inhibitors’ and work in a very similar way.

These medicines work in the presence of sexual stimulation. Once aroused, a natural chemical is released, which the PDE5 inhibitors rely on to work with.

Once this natural chemical is released, a chain reaction begins, relaxing the smooth muscle inside the penis. There is then an increase in blood flow into the penis allowing the penis to can become erect. What’s the difference between Sildenafil and Tadalafil?

Sildenafil has been around since 1998, which means a lot is known about the positive effects and also the side effects. It works within an hour of taking the medication and for its full effect, should be taken on an empty stomach. The effects of Sildenafil generally last for four to five hours.

Viagra was developed by the pharmaceutical company Pfizer and they were the only company that could legally manufacture it until 2013.

In 2013, their patent expired which meant that other companies could produce their own erectile dysfunction medications containing the active ingredient sildenafil. When you see the medication ‘Sildenafil’, you can be assured that it contains exactly the same active ingredient as Viagra. However, as it is a generic version rather than the brand, it is considerably cheaper. The more common side effects of Sildenafil can include headache, nausea, stuffy nose, flushing and indigestion. There are also some rarer side effects; you should always read the accompanying leaflet that comes with any medicine before taking it. Sildenafil is taken on an as needed basis, usually at a dose of 50mg. These may be increased to 100mg if the standard dose is ineffective, or lowered to 25mg if mild side-effects are experienced.

The dosing may be different depending on your medical history, so your doctor should discuss an appropriate starting dose with you. In 2003, a company named Eli Lilly introduced Cialis as an alternative ED medication.

The company had the patent on Tadalafil until November 2017.

Similarly to Viagra, now that the patent has expired, other companies are permitted to make their own version of Tadalafil, the active ingredient in Cialis.

Again, as it is a generic version of the brand, Cialis, the medication is considerably cheaper. Tadalafil has two formulations – one that can be taken 'as required', and one that can be taken daily. The 'as required' Tadalafil (generic Cialis) has an advantage over Sildenafil in that it lasts a lot longer – up to 36 hours (compared with 4-5 hours for Sildenafil).

Some men prefer this as it allows for more spontaneity.

Tadalafil also works faster than Sildenafil – it generally works within 30 minutes, though for some men it can take up to an hour.

The action of Tadalafil is not affected by food, and this is another reason why some men may prefer it. The standard 'as required' Tadalafil dose is 10mg, which may be increased to a maximum of 20mg if the medication is ineffective. This dose also depends on your medical history, so your doctor will discuss the appropriate starting dose with you.

The daily version of Tadalafil known by its brand name Cialis Daily, is recommended for those who have sex more than twice a week. The medication is taken every day and after approximately 5 days, should have its full effect. By taking the medication in this way, there is a steady, constant dose in the body.

The initial dosing is 2.5mg once daily, which can be increased to 5mg if the initial dosing is ineffective. One of the disadvantages of Tadalafil is that as the medication lasts in the body for longer, if you get side effects with the medication, these can last longer as well. The side effects are similar to all ED medications - headache, nausea, stuffy nose, flushing, indigestion, but as mentioned before there can be some other rarer side effects; you should always check the leaflet that comes with the medication before taking it. Different ED medications suit different people so it is difficult to tell which would work best for you until you’ve tried each one.

In our experience, men often prefer Tadalafil as it lasts longer, works faster and can be taken with food. Having said that, some men find that Tadalafil does not suit them, so they prefer to stick with Sildenafil.

You can request both Sildenafil and Tadalafil safely online through the LloydsPharmacy’s Online Doctor service. If appropriate, our GPs ca prescribe you treatment for Same-Day Collection, Next-Day delivery or FREE Standard Delivery.

If you’re unsure which ED treatment will be best for you then take our free ED assessment and our clinicians will help you decide.

Erectile dysfunction (ED) — impotence — is an extremely common problem that affects up to 22% of American men, mostly in the older age groups.

Once considered primarily a psychological disorder, it is now clear that most cases of impotence have a physical basis.

The leading causes are the chronic diseases that damage blood vessels and nerves vital for normal erectile function; diabetes, atherosclerosis, and hypertension head the list.

The medications used to treat these problems and other ailments can also contribute to impotence.

Hormonal abnormalities are less common, but they are particularly important to detect since they can be corrected.

That's also true of the psychological problems that cause up to 15% of impotence; table 1 below summarizes some of the differences between psychological and physical impotence. For many men, the hardest thing is to admit the problem. Every man experiences erectile dysfunction from time to time, but doctors define impotence as the inability to get and keep an erection satisfactorily for penetration on at least 25% of attempts. It's a good definition, but it should not be used to exclude men with less severe difficulties from getting treatment. A simple questionnaire can help you determine if you are having erectile dysfunction (see below). If so, talk to a primary care doctor, urologist, or endocrinologist.

Which Drug for Erectile Dysfunction Is Better: Viagra or Cialis? Four drugs have been approved for erectile dysfunction. Which is best depends on your individual needs and desires. The Food and Drug Administration has approved four similar drugs for erectile dysfunction, sold under such names as Viagra (sildenafil), Cialis (tadalafil), Levitra (vardenafil) and Stendra (avanafil).

They all work the same way, producing an erection by increasing blood flow to the penis.

Which drug is best may depend on your preference for quick onset versus long duration and your individual medical needs. The discovery of Viagra is one of the classic stories of serendipity in drug development. In the 1980s, the pharmaceutical company Pfizer began studying sildenafil, the generic name for Viagra, as a treatment for heart disease. It didn’t work, but the men in the study developed unusually strong, long-lasting erections. All four of the currently approved drugs seem to be equally good at producing erections.

But it is difficult to be more definitive in evaluating their efficacy, because few studies directly comparing them have been conducted, a common problem with many drugs.

Since all four drugs are similarly effective, the answer to which drug is best will depend on other attributes, such as side effects, drug interactions, speed of onset and duration of action. Headache, flushing and upset stomach are the most common side effects. And, in rare cases, all can cause a persistent and sometimes painful erection that will not go down, a over the counter ed pills at rite aid condition called priapism that can result in permanent damage if not treated promptly.

Drug interactions are largely similar, with the most important interaction being a contraindication to nitrate-containing drugs, such as nitroglycerin, commonly used to treat angina. Time of onset is an important difference between the drugs.

While all take effect within an hour, Stendra is the fastest acting, often taking effect within 15 minutes.