  Drug Name
Viagra (Sildenafil)
Drug Uses
Viagra is used to treat impotence in men. Viagra increases the body's ability to achieve and maintain an erection during sexual stimulation. Viagra does not protect you from getting sexually transmitted diseases, including HIV.
How Taken
Viagra comes as a tablet to take it orally. It should be taken as needed about 1 hour before sexual activity. However, Viagra can be taken anytime from 4 hours to 30 minutes before sexual activity. Viagra should not be taken more than once a day. Do not take more or less of it or take it more often than prescribed by your doctor.
Drug Class and Mechanism
It has been estimated that impotence affects 140 million men worldwide. Over half of all men with impotence are thought to have some physical (medical) cause. The remainder are believed to have psychogenic causes of impotence. Medical causes of impotence include diabetes and circulatory, neurological or urological conditions.
Penile erection is caused by the engorgement of the penis with blood. This engorgement occurs when the blood vessels delivering blood to the penis increase the delivery of blood and the blood vessels carrying blood away from the penis decrease the removal of blood. Under normal conditions, sexual stimulation leads to the production and release of nitric oxide in the penis. Nitric oxide then activates the enzyme, guanylate cyclase, which causes the production of cyclic guanosine monophosphate (cGMP). It is the cGMP that is primarily responsible for the erection by affecting the amount of blood that the blood vessels deliver and remove from the penis.
Sildenafil also reduces the pressure in the pulmonary artery in a serious condition called pulmonary arterial hypertension.
Sildenafil inhibits an enzyme called phosphodiesterase-5 (PDE5) which destroys the cGMP. Thus, sildenafil prevents the destruction of cGMP and allows cGMP to accumulate and persist longer. The longer cGMP persists, the more prolonged the engorgement of the penis.
Missed Dose
Viagra is used as needed, so you are not likely to miss a dose.
Storage
Keep Viagra out of the reach of children. Keep Viagra in its original container. Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F).
Warnings/Precautions
Before taking Viagra, tell your doctor if you have had a heart attack, stroke, or life-threatening irregular heartbeats within the last six months; have a history of heart failure; have coronary artery disease; have angina; have high or low blood pressure; have liver problems; have kidney problems; have ever had blood problems, including sickle cell anemia or leukemia; have a bleeding disorder; have a stomach ulcer; have retinitis pigmentosa (an inherited condition of the eye); have a physical deformity of the penis such as Peyronie's disease; have a condition that could lead to prolonged and painful erections, such as a tumor of the bone marrow, sickle cell anemia, or leukemia; or are taking another medicine to treat impotence. You may not be able to take Viagra, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
Although Viagra is not indicated for use by women, it is in the FDA pregnancy category B. This means that Viagra is not expected to be harmful to an unborn baby. Women should not take Viagra. It is not known whether Viagra passes into breast milk. If you are over 65 years of age, you may be more likely to experience side effects from Viagra. Your doctor may prescribe a lower dose of this medication.
Possible Side Effects
Like all medicines, Viagra can cause some side effects. These effects are usually mild to moderate and usually don't last longer than a few hours. Some of these side effects are more likely to occur with higher doses. The most common side effects of Viagra are headache, flushing of the face, and upset stomach. Less common side effects that may occur are temporary changes in color vision (such as trouble telling the difference between blue and green objects or having a blue color tinge to them), eyes being more sensitive to light, or blurred vision. In rare instances, men have reported an erection that lasts many hours. You should call a doctor immediately if you ever have an erection that lasts more than 4 hours.
If not treated right away, permanent damage to your penis could occur. Heart attack, stroke, irregular heartbeats, and death have been reported rarely in men taking Viagra. Most, but not all, of these men had heart problems before taking this medicine. It is not possible to determine whether these events were directly related to Viagra.
More Information
- If you experience any of the following serious side effects, stop taking sildenafil and seek emergency medical attention or notify your doctor immediately:
- an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
- chest pain or an irregular heartbeat;
- swelling of the ankles or legs;
- shortness of breath;
- prolonged or severe dizziness;
- a prolonged (lasting longer than 4 hours) or painful erection; or
- dizziness, nausea, or angina (pain, tightness, discomfort, numbness, or tingling in the chest, arms, neck, or jaw).
- Other, less serious side effects may be more likely to occur. Continue to take sildenafil and talk to your doctor if you experience
- flushing;
- mild dizziness;
- headache;
- nasal congestion;
- diarrhea;
- temporary blue tint in vision or other vision abnormalities; or
- itching or a rash.
- Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
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