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What is Viagra?

Viagra or Sildenafil is a phosphodiesterase inhibitor meant to treat erectile dysfunction (ED). As a medical condition, ED is characterized by a lack of blood flow into the penis resulting in inability of getting and/or maintaining an erection. To believe the current statistical data, more than 50% of men over 40 years old suffer from ED and need professional medical assistance.

Patented in 1993 by Pfizer and approved in 1998 by FDA, Viagra became the first oral drug for ED treatment. Before the medication appeared on the market, penile implants, vacuum pumps and penis injections had been used. Nevertheless, these methods were neither effective nor safe enough, so Viagra truly revolutionized in overcoming ED.

At the beginning Viagra was invented to treat angina and high blood pressure. Dilating the coronary arteries which feed the heart muscles, the medicine was expected to remove the pain in patients who suffered from angina. However, after clinical trials in 1991, researchers found out that the drug wasn't effective for this purpose but had some unexpected side effects. Thus, some volunteers reported that taking the pill contributed much to a higher blood flow into the penis, ensuring better erections. From that moment Viagra had been developed as an ED drug.

The first clinical tests proved the ultimate efficacy of Viagra. Thus, 3,000 of patients from 19 to 87 years old admitted considerable erection improvements. Those who took a 50mg dose reported significant changes in their erectile ability almost in 90% of cases. Since 1998 more than 23 million of men who had difficulties in achieving an erection had tested Viagra and found it quite useful.

Mechanism of action

The effect that Viagra provokes can be better explained if one considers its contents, as well as some important chemical processes in the body. This medication belongs to the group of PDE5-inhibiting drugs, or phosphodiesterase type 5 inhibitors. Having appeared in blood, this substance starts blocking the degradative influence of phosphodiesterase type 5 in the smooth muscle cells. As a result, the vessels that supply the penis corpus cavernosum get more blood, and an erection occurs. Knowing that PDE5-inhibiting medications are good for vessels distension, doctors use them not only for erectile dysfunction but also for pulmonary hypertension, as the smooth muscles in lungs contain PDE5 as well.

Viagra is metabolized by hepatic enzymes. It isn't recommended to take Viagra with fatty meals; otherwise liver and kidney which excrete this drug may have difficulties with its absorption.

One of the main facts about Viagra and PDE5 inhibitors is that they act only after sexual stimulation, so if a patient took the drug but didn't meet his partner, he wouldn't experience any erection.

Recommended dosage of Viagra

Viagra comes in 25mg, 50mg and 100mg pills. The dosage varies from patient to patient, depending on the age, health condition and related factors. For example, if a patient is over 65, as well as if he has liver or kidney problems, a 25mg pill will be enough for him. Another critical thing is drug interaction, so if one is taking ritonavir, itraconazole, erythromycin, saquinavir or ketoconazole, the dose should be limited by 25mg too. All in all, the dosage must be adjusted individually, and it is impossible to share one.

The drug is taken only with an empty stomach, 30 minutes to 4 hours before the intercourse. The action can last up to 5 hours.

Although any overdose of Viagra hasn't been reported, taking an excessive amount of the drug may lead to serious consequences. In case you suspect an overdose, you should go to the doctor right away.

Viagra side effects

Among the most common side effects are dizziness, fainting, drowsiness, blurred vision and lightheadedness.

Special warnings about Viagra

You ought not to mix Viagra with alcohol or to take it if:

• you are allergic to its ingredients
• you are using nitrates, like isosorbide and nitroglycerin
• your doctor told that you had to forbear from sexual activity because of heart problems
• you are under recreational medications or “poppers”, such as amyl nitrate and butyl nitrate

Moreover, there are certain medical conditions that may interact with Viagra. Use Viagra with caution in case:

• you are currently taking any other medicine, dietary supplement or herbal preparation
• you suffer from allergies to certain drugs, foods and other substances
• you have a history of eye problems, like sudden vision loss, macular degeneration, retinitis pigmentosa or optic neuropathy
• you have a history of high and low blood pressure, liver and kidney problems, bleeding problems, ulcers, blood vessel problems and heart problems, such as irregular heartbeat, angina, aortic stenosis and heart failure
• you have a deformed penis (for instance, Peyronie disease or cavernosal fibrosis), sickle cell anemia, multiple myeloma, leukemia or other blood problems, as well as any other condition that may cause priapism, i.e. a prolonged erection
• you have a history of life-threatening irregular heartbeat, heart attack, stroke within the past 6 months

The following drugs aren't recommended to be taken with Viagra:

• alpha-blockers (like doxazosin)
• amlodipine
• medicines for high blood pressure
• nitrates (such as isosorbide and nitroglycerin)
• nitroprusside
• azole antifungals (for example, itraconazole)
• cimetidine
• H2 agonists (like famotidine)
• HIV protease inhibitors (for instance, ritonavir)
• macrolide antibiotics (e.g. Erythromycin)
• telithromycin
• bosentan
• rifampin