Viagra ( Sildenafil )

Disclaimer: The information provided on this page is not a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns about your health, please talk to a doctor.

What is Viagra?

Viagra® (nicknamed “the little blue pill”) is a drug that is used to treat erectile dysfunction (ED). It comes in three doses, 25 mg, 50 mg, and 100 mg. The 50 mg dose is the most commonly used dose, although some people may benefit from higher or lower doses. Viagra® is part of a “family” of medicines used to treat ED called phosphodiesterase-5 inhibitors (PDE5i). Other drugs in this family include Cialis (tadalafil), Levitra (vardenafil), and Stendra (avanafil). All of these drugs have the same mechanism of action, but there are subtle differences that may cause someone to choose one drug over the others.

What is Generic Viagra?

Viagra® was originally patented by Pfizer and brought to the US market in 1998. It is FDA-approved to treat erectile dysfunction (ED). After the patent expired, the FDA gave permission to other drug companies to market a generic version of Viagra®. The FDA requires generic drugs to be bioequivalent to the brand name version. This means that they act the same way in the body and are expected to produce the same effects as the original brand name drug. Generic drugs are generally much cheaper than the original brand name drug, and most drugs prescribed in the US are generic.

What is Sildenafil Citrate?

Sildenafil citrate is the chemical name of the active ingredient in Viagra®. Sildenafil citrate is also sold in 20 mg tablets as the generic version of a drug called Revatio®, which is FDA approved for treating pulmonary hypertension. Roman-affiliated physicians have the discretion to prescribe 20 mg sildenafil tablets for ED in doses ranging between 20 mg and 100 mg if they believe that it is an appropriate course of treatment for a particular patient. Sildenafil 20 mg tablets for ED is an off-label usage of the medication. It is up to the medical judgment of the doctor to decide if off-label treatment is appropriate for a patient based on his unique medical history, symptoms, and preferences. The Roman Pharmacy Network is able to fill prescriptions for sildenafil 20 mg tablets that are issued by a Roman-affiliated physician.

Does Roman Offer Genuine Viagra?

Roman offers genuine, branded Viagra® and generic Viagra® to treat erectile dysfunction (ED). Roman also offers sildenafil in 20 mg tablets, which can be prescribed by doctors off-label to treat ED in doses ranging between 20 mg and 100 mg if they find it medically appropriate to do so.

How Does Viagra Work?

In order to understand how Viagra® works to treat ED, it’s important to first understand the basics of how erections work. Erotic stimulation (by physical touch, erotic thoughts, smells, etc) causes the local tissues to release nitric oxide (NO), which increases the amount of a chemical called cyclic guanosine monophosphate (cGMP). cGMP causes the muscles on the sides of the penis, the corpora cavernosa, to relax allowing blood to rush into the penis. At the same time veins that drain blood from the penis get compressed causing the increased blood to be trapped in the penis causing an erection. An enzyme called phosphodiesterase-5 breaks down cGMP leading the penis to return to its flaccid state. PDE5 inhibitors (PDE5i), like Viagra®, block this enzyme, leading to higher levels of cGMP and improving the ability to obtain and maintain an erection.

How Should I Take Viagra?

Viagra® should be taken 30–60 minutes before sex. It’s important to take it without a meal because fat in a meal can decrease and delay its absorption, which can lower Viagra’s effectiveness. Even though the instructions are to take it 30–60 minutes before sex, Viagra® lasts in the body for up to 6–8 hours.

How Long Does Viagra Take to Work?

Viagra® is a short acting medication with a rapid onset. It should be taken 30–60 minutes before sex, and it reaches peak blood levels in 60 minutes on average. Fat in a meal can delay the effects of Viagra® and also decrease the amount that is absorbed. Remember that Viagra® will not give you a spontaneous erection without sexual stimulation.

How Long Does Viagra Last?

Viagra® is a short acting drug with an average half-life of 4–5 hours, which means that half the medicine is gone from the body after 4–5 hours in healthy people. The time that it takes to eliminate Viagra® may be prolonged in older people and people with liver or kidney disease and the drug may work longer in these people.

Can Viagra Have Permanent Effects?

Viagra does not have permanent effects on the body once it is broken down. It is only effective for as long as it is in the body. Some people may find they need more medication after taking ED medication for a long time or it may not work as well as it used to. However, this is not because the medicine is having permanent effects. This happens because erectile function normally decreases with age. In some cases, erectile function may also worsen due to progression of the underlying disease that is causing ED (e.g., diabetes, vascular disease).

What Should I Tell My Doctor

Tell your doctor if you have any problems with your heart, liver, kidneys, vision disorders, bleeding disorders, or penile deformities. Tell your doctor about all prescription medications, over the counter medications, and dietary supplements you are taking. For more safety information, please see the important safety information below.

Common Side Effects of Viagra

The most common side effects of Viagra® include headaches, facial flushing, stuffy nose, and upset stomach. Serious side effects that are rare include an erection that will not resolve even after 3–4 hours (priapism), hearing loss, which can be sudden, and vision loss in one or both eyes. For more information about side effects, see Viagra® side effects below.

What Happens if I Overdose?

Taking more than the recommended amount of Viagra® or sildenafil citrate greatly increases your risk of side effects, including severe ones that can be dangerous, such as severe low blood pressure or an erection that won’t go away even after 4 or more hours (priapism). Never take more than the amount prescribed to you by your doctor. If you have any severe side effects after taking more than the recommended amount, or even after taking the amount of medicine prescribed to you, seek out emergency medical attention immediately.

Is Buying Viagra Online Safe?

Buying medication online can have risks when the source is not reputable. One study showed that 77% of Viagra sold online was counterfeit. Counterfeit PDE5i can have variable amounts of the active drug ranging from 0%–200+% of the drug. In cases where the active ingredient is present in lower amounts than expected, this can mean lack of effectiveness even though the same dose of active drug may work well in a given individual. In cases where much more active drug than listed is included, there is a higher potential for side effects, including dangerous ones like extremely low blood pressure or an erection that won’t go away even after 4 or more hours (priapism). It is also common for counterfeit drugs to contain harmful ingredients like talcum powder, commercial paint, and printer ink.

With Roman, you can always be sure you are getting genuine medication with active ingredients in the correct amount without harmful additives. Roman drugs are manufactured by pharmaceutical companies that are regulated by the FDA. In fact you will likely find many of the same manufacturers we use in your local pharmacy. With Roman, you never need to worry about what’s actually in the pills you are taking.

IMPORTANT SAFETY INFORMATION

What Should You Know Before Taking Viagra

Contraindications

Who should not take Viagra® or generic Viagra®?

Do not take Viagra® or generic Viagra® if you:

  • take medicines called nitrates (such as nitroglycerin)
  • use street drugs called “poppers” such as amyl nitrate or amyl nitrite, and butyl nitrate
  • take any medicines called guanylate cyclase stimulators such as riociguat (Adempas)
  • are allergic to sildenafil, as contained in Viagra® and Revatio, or any of the ingredients in Viagra®. See the end of this leaflet for a complete list of ingredients in Viagra®.

What should I tell my healthcare provider before taking Viagra® or generic Viagra®?

To make sure Viagra® is safe for you, tell your healthcare provider if you have any of the following before you take Viagra® or generic Viagra®l:

  • Have or have had heart problems such as a heart attack,irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure
  • Have had heart surgery within the last 6 months
  • Have pulmonary hypertension
  • Have had a stroke
  • Have low blood pressure, or high blood pressure that is not controlled
  • Have a deformed penis shape
  • Have had an erection that lasted for more than 4 hours
  • Have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia
  • Have retinitis pigmentosa, a rare genetic (runs in families) eye disease
  • Have ever had severe vision loss, including an eye problem called NAION
  • Have bleeding problems
  • Have or have had stomach or intestinal ulcers
  • Have liver problems
  • Have kidney problems or are having kidney dialysis
  • Have any other medical conditions

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Viagra® and generic Viagra® may affect the way other medicines work, and other medicines may affect the way Viagra® and generic Viagra® works, causing side effects.

Drug Interactions

Tell your healthcare provider if you take any of the following because these drugs interact with Viagra® and generic Viagra®:

  • Medicines called nitrates
  • Medicines called guanylate cyclase stimulators such as Adempas® (riociguat)
  • Medicines called alpha-blockers such as Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), Jalyn® (dutasteride and tamsulosin HCl), or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of VIAGRA® or generic VIAGRA® with alpha-blockers can lead to a drop in blood pressure or to fainting
  • Medicines called HIV protease inhibitors, such as ritonavir (Norvir®), indinavir sulfate (Crixivan®), saquinavir (Fortovase® or Invirase®), or atazanavir sulfate (Reyataz®)
  • Oral antifungal medicines, such as ketoconazole (Nizoral®) and itraconazole (Sporanox®)
  • Antibiotics, such as clarithromycin (Biaxin®), telithromycin (Ketek®), or erythromycin
  • Other medicines that treat high blood pressure
  • Other medicines or treatments for ED
  • Viagra® and generic Viagra® contain sildenafil, which is the same medicine found in another drug called Revatio®. Revatio® is used to treat a rare disease called pulmonary arterial hypertension (PAH). Viagra® and generic Viagra® should not be used with Revatio® or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Adcirca [tadalafil])

Ask your healthcare provider or pharmacist for a list of these medicines, if you are not sure.

Know the medicines you take. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine.

Viagra Side Effects

What are the possible side effects of Viagra® and generic Viagra®?

Viagra® and generic Viagra® can cause serious side effects. Rarely reported side effects include:

  • an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, get medical help right away. If it is not treated right away, priapism can permanently damage your penis.
  • sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). It is uncertain whether PDE5 inhibitors directly cause the vision loss. Stop taking Viagra® and call your healthcare provider right away if you have sudden vision loss in one or both eyes.
  • sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness. If you have these symptoms, stop taking Viagra® or generic Viagra® and contact a doctor right away.

The most common side effects of Viagra® and generic Viagra® are:

  • headache
  • flushing
  • upset stomach
  • abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision
  • stuffy or runny nose
  • back pain
  • muscle pain
  • nausea
  • dizziness
  • Rash

In addition, heart attack, stroke, irregular heartbeats and death have happened rarely in men taking Viagra®. Most, but not all, of these men had heart problems before taking Viagra®. It is not known if Viagra® caused these problems.

Tell your healthcare provider if you have any side effect that bothers you or does not go away.

These are not all the possible side effects of Viagra® and generic Viagra®. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

POPULAR QUESTIONS

Can I use Viagra with alcohol?

It is not recommended to mix alcohol with Viagra.

Can I take Viagra more than once per day?

No. Do not exceed one dose in a 24 hour period

Is Viagra affected by food?

You can use Viagra with or without food. However, fatty food has been shown to reduce the rate of absorption and strength. Viagra will have the strongest effect on an empty stomach. Also, it is worth noting grapefruit juice can possibly affect the absorption of Viagra.

Can I get a Viagra prescription online?

Yes, you can get a prescription through a Roman online visit for Erectile Dysfunction or an online visit for Premature Ejaculation , if determined appropriate by a U.S. licensed physician.

What is off-label usage of medication?

Roman-affiliated physicians have the discretion to prescribe 20mg Sildenafil for ED if they believe that it is an appropriate course of treatment for a particular patient. 20mg Sildenafil for ED is an off-label usage of the medication, and it is up to the medical judgment of the doctor to decide if such treatment is appropriate based on each patient’s unique medical history, symptoms, and preferences. The Roman Pharmacy Network is able to fill prescriptions for 20mg Sildenafil that are issued by a Roman-affiliated physician.

ADDITIONAL RESOURCES

We recommend reading the links below to understand all of the potential benefits and risks of the medications: