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Birds eye view

Main active ingredient: sildenafil citrate, commonly marketed for erectile dysfunction (ED) under several brand names including Viagra and Viagra Professional.

Common tablet strengths associated with professional preparations include 50 mg and 100 mg. The licensed primary indication is treatment of erectile dysfunction in adult men. Note: sildenafil is also used to treat pulmonary arterial hypertension under different brand names and dosing schedules; do not swap products without professional advice.

This page contains navigation to statute related information and typical pricing information advice in the UK; see the sections Status of legal standing in the United Kingdom and Prices for goods in the UK review the details.

An explanation of the way it works

Sildenafil is known to inhibit PDE5. When sexual stimulation occurs, nitric oxide is released and leads to relaxation of smooth muscle in the penis. By inhibiting PDE5, sildenafil helps keep cyclic GMP levels higher, which promotes increased blood flow into the corpora cavernosa and supports an erection. Without sexual arousal, the medicine will not be effective.

Guidance on how much to take and a guide to using

The following are general dosing notes; always adhere to the advice given by a prescriber or pharmacist.

• Typical starting dose: 50 mg for many adults. A prescriber may increase to 100 mg or reduce to 25 mg based on response and medication side effects.
• What is the right time to take it?: commonly taken 15 to 60 minutes before sexual activity. Some people report onset as early as 15 minutes; others prefer to allow 30 to 60 minutes.
• Maximum frequency: do not take more than one dose within a 24 hour period.
• Food effects: a high-fat meal can slow absorption and delay onset; a lighter meal usually results in faster action.
• Grapefruit and grapefruit juice should be avoided as they can increase blood levels and adverse health effects; see Social exchanges among drugs.

If you experience chest pain, pronounced dizziness, or sudden visual problems after taking sildenafil, stop use and seek urgent medical attention.

Risk mitigation steps

Before using sildenafil, inform the pharmacist or prescriber about any medical history and current medicines. Key considerations include:

• Allergy: do not use if you have a known hypersensitivity to sildenafil or any tablet component.
• Cardiac history: discuss use if you have coronary heart disease, recent heart attack or stroke, irregular heartbeat, or uncontrolled low or high blood pressure.
• Eyes and hearing: report previous diagnoses such as retinitis pigmentosa or prior episodes of sudden vision loss, and any sudden hearing loss.
• Hepatic impairment or renal dysfunction: dose changes may be needed for significant liver disease or severe renal dysfunction.
• Penile abnormalities: caution in anatomical deformation of the penis (for example Peyronie disease) or conditions that predispose to priapism.
• Older adults: may be more sensitive to indirect effects such as hypotension and dizziness.
• Beverage that contains ethanol: limit alcohol intake since it may both reduce erectile response and increase dizziness.

For tracking interactions helps measure engagement. with specific medicines, consult Pharmacologic contact and responses with others are the core of collaboration..

Cautions against use due to medical reasons

• Concomitant use with any nitrates (for example glyceryl trinitrate, isosorbide mononitrate) or recreational nitrite inhalants ("poppers") is strictly contraindicated due to severe risk of dangerously low blood pressure.
• Concurrent therapy with guanylate cyclase stimulators such as riociguat is not permitted.
• Known allergy to sildenafil or any excipient in the formulation.
• Not licensed for use in women or in children under 18 years for ED.
• Should not be used if a clinician has advised avoidance of sexual activity because of significant cardiovascular risk.

Possible reactions to the medication

The bulk of adverse reactions are mild and transient. Commonly reported reactions include:

• Pain in the head plus facial flushing
• Dyspeptic symptoms or dyspepsia signs
• Obstructed nasal passages
• Dizziness or a lightheaded sensation
• Watery stools

If you notice anything out of the ordinary, seek medical care promptly. any serious symptoms such as:

• Chest pressure, fainting, or sudden dizziness.
• Sudden loss or serious change in vision
• Sudden decrease or loss of hearing, with or without tinnitus
• Allergic reactions including swelling or breathing difficulties
• Priapism: an erection that is painful or lasts longer than four hours

Cooperative exchanges of medications

Certain medicines and substances alter the safety or effect of sildenafil. Remarkable dialogues are:

• Nitrates and nitrites: combining with nitrates or "poppers" can cause life-threatening hypotension.
• Alpha blockers and antihypertensive agents: may produce marked low blood pressure; supervise dosing carefully and separate timing where advised.
• Other PDE5 inhibitors: do not take sildenafil together with tadalafil, vardenafil, avanafil or additional sildenafil formulations.
• Strong CYP3A4 inhibitors (for example ritonavir, cobicistat, ketoconazole, itraconazole, clarithromycin): these can increase sildenafil concentrations and may require dose adjustment or avoidance.
• Grapefruit products: can increase plasma levels and also the chance of harmful effects.
• Excessive alcohol: may worsen dizziness and impair erectile response.

Always provide a full current medication list to your prescriber and pharmacist.

Dose not taken

Sildenafil for ED is taken on an as-needed basis rather than a fixed daily schedule. Do not take more of the medicine to replace a dose you did not take. Comply with the guidance outlined in How much to take and directions for timing of future doses.

Overdose risk

Signs of the person overdosed can include strong dizziness, fainting, chest pain, irregular heartbeat, severe nausea, or visual disturbances. If you suspect someone has taken too much sildenafil, seek urgent medical care. In the UK call 999 for emergencies or 111 for non-emergency medical advice.

Short term in computing, storage means the capacity to retain data over time.

• Store at normal room temperature, ideally between 20 and 25 degrees C, away from excess heat and moisture.
• Do not leave medicines in the bathroom. Keep all tablets out of the sight and reach of children and pets.
• Use before the expiry date shown on the packaging. Return unused medicines to a pharmacy for safe disposal where local services are available.

Comparable medicines and different choices

Several other licensed options exist for treating ED; choice depends on how long you want the effect to last, how quickly you need onset, side effect profile, and cost. Typical option choices include:

• Tadalafil (brand Cialis): longer duration of action, up to 36 hours; available as on-demand and low-dose daily regimens.
• Avanafil (brand Spedra): often reported to act faster in some users, with a duration around 6 hours.
• Vardenafil (brand Levitra): onset and duration similar to sildenafil for many people, typically 4 to 6 hours.

Non-drug options include vacuum erection devices, psychosexual counselling, lifestyle interventions (weight loss, smoking cessation, increased exercise), and management of underlying conditions such as diabetes and hypertension.

For pulmonary arterial hypertension, sildenafil is marketed under different names (for example Revatio) and different substitutes such as tadalafil (Adcirca) are used; these require specialist supervision and must not be interchanged without professional leadership.

What things cost in the UK

Prices vary by retailer, pack size, brand, and whether you obtain the drug over the counter, privately by prescription, or on the NHS. The figures below are approximate and intended only as a guide in GBP:

• Viagra Connect 50 mg (pharmacy supply without a prescription): roughly 19 to 25 GBP for a pack of 4 tablets; unit costs fall with larger packs.
• Generic sildenafil (50 mg or 100 mg) bought through private online clinics or on private prescription: commonly around 1 to 3 GBP per tablet depending on quantity.
• Branded Viagra 100 mg on private prescription: typically 8 to 15 GBP per tablet depending on the supplier.
• NHS prescriptions (where applicable) may require the standard prescription charge per item in England; ED medicines are often provided privately unless clinical criteria for NHS supply are met.

Always compare reputable UK pharmacists and include the cost of any consultation and postage when assessing total price. For safe purchase routes see The status of the law in Great Britain.

How legal standing of a person is defined in the UK

• Classification: sildenafil 50 mg sold as Viagra Connect is classified as a Pharmacy (P) medicine and may be supplied by a pharmacist following an assessment. Other strengths and many branded packs remain Prescription Only Medicine (POM).
• Age and assessment: supplies are for adults aged 18 and over. Pharmacists and prescribers will evaluate suitability based on health, medicines, and risk factors.
• Online purchases: use UK-registered pharmacies and look for General Pharmaceutical Council (GPhC) registration and MHRA regulation. Avoid unverified international sites to reduce risk of counterfeit or unsafe products.
• Personal import rules: importing prescription-only medicines without an appropriate UK prescription can result in seizure by border authorities. Obtain medicines through legal UK channels.
• Driving and machinery: do not drive or operate machinery if you experience dizziness or visual disturbances after taking sildenafil.
• Sport: sildenafil is not classified as a prohibited substance by major anti-doping authorities for routine use; do not use for performance enhancement and follow sporting body guidance where applicable.

Questions people ask most often

How fast does sildenafil act and how long does it last? Many men notice effects within 15 to 60 minutes and benefit may continue for about 4 to 6 hours, although this varies.

Should I take it with meals or with an alcoholic drink? A high-fat meal can delay absorption. Limit alcohol because it can reduce erectile response and increase after effects like dizziness.

Can I combine sildenafil with nitrates? No. Combining with nitrates or "poppers" is dangerous. See Drug the exchange that happens when people meet system monitoring.

Is it safe to take more than one tablet? Only one dose may be taken in a 24-hour period. If the effect is inadequate, discuss dose adjustment or an the other possibility with a clinician.

Are there any differences among Viagra, Viagra Connect and generic sildenafil? The active ingredient is the same: sildenafil. Differences are in branding, available strengths, supply route (pharmacy or prescription) and price. Your pharmacist can advise on suitability.