Viagra (Sildenafil Citrate) is widely used to promote penile erection in men suffering from organic or phsychogenic erectile dysfunction. It improves the level of hardness achieved and the length of time such hardness is maintained. However, sexual arousal is still required for Viagra to be effective meaning that erectle function can be controlled.
Sildenafil Citrate (Viagra) is also used to treat pulmonary arterial hypertension.
To Promote penile erection Viagra is a selective inhibitor of cyclic guanosine monophosphate-specific phosphodiesterase type-5 inhibitor. By its action it enhances the effect of nitric oxide which in turn activates guanylate cyclase, resulting in increased levels of cyclic guanosine monophosphate. The result of this is to relax the corpus cavernosum in the penis, allowing greater influx of blood. It is this influx of blood which causes penile erection.
Sexual stimulation is still required for the effect to take place. Peak effect is at 30 minutes following administration, after which effectiveness reduces to 0.001% at90 minutes.
For pulmonary hypertension the same mechanism also relaxes
smooth muscle elsewhere in the body resulting in vasodilation of the pulmonary vascular bed and, to a lesser degree, in the systemic circulation.
It is broken down in the liver, and the metabolites excreted mostly in the faeces, with some (13%) in urine.
Viagra should not be taken if you suffer from hypotension, recent stroke, unstable angina, myocardial infarction, severe hepatic or renal impairment, active peptic ulceration or any bleeding disorders.
Do not take this medication if you are already taking ritonavir, nicorandii, nitrates (e.g. glycerol trinitrate or amyl nitrate).
Caution is advised if you suffer from cardiovascular disease, anatomical deformation of the penis, sickle cell disease, multiple myeloma or leukaemia.
If, on taking Sildenafil (Viagra) your erection has not subsided after 4 hours, you should seek immediate medical help to avoid tissue damage. However, this is a rare event.
Do not take within 4 hours of taking alpha-blockers.
The effectiveness of Viagra may be increased (thus requiring a lower dose), by clarithromycin, telithromycin, erythromycin, itraconazole, ketoconazele, amprenavir, nelfinavir, saquinavir.
The most common side effects are: headache (16%) , hot flushes (10%), dyspepsia (7%) and nasal congestion (4%).
Less common side effects include: abnormal vision, diarrhoea, dizziness (caused by lowered blood pressure), and rash.
Rare side effects include: myocardial infarction, hypotension and haemorrhage (pulmonary or subarachnoid).
For erectile dysfunction Between 25mg and 100mg (usually 50mg is sufficient) taken 30 minutes to 1 hour before sexual intercourse (the amount of time needed is variable). It is advisable to take one dose only in any one 24 hour period.
For pulmonary hypertension: generally 20mg three times a day, with 4-6 hours between doses with or without food. Higher doses have no greater benefit.
It may take longer to be effective is taken with a high fat meal
Store at room temperature out of reach of children.
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