What is Sildenafil?

Sildenafil is a drug mainly used to treat ED and pulmonary arterial hypertension (PAH). It belongs to a class of drugs known as phosphodiesterase type 5 (PDE5) inhibitorsis. For ED, it works by increasing blood flow to the penis during sexual stimulation causing an errection where as for PAH its opposite. In PAH, Sidenafil works by relaxing the blood vessels in the lungs allowing blood to flow more easily. It’s commonly sold under the brand name Viagra for ED tratment, while for PAH it is sold under the brand name Revatio.

Does sildenafil work to treat ED?

The answer is “Yes, Sildenafil is effective in treating ED”. ED occurs mainly due to inadequate blood flow to the penis during sexual arousal. Sildenafil supports maintaining an erect penis by increasing the blood flow to it. Let’s grasp in detail about how sildenafil works:

When a man gets aroused, certain chemicals in his body cause the penis muscles to relax. This relaxation allows blood to flow into the penis, making it hard and erect. But sometimes, especially in men with ED, this process doesn't work as well as it should.

That's where sildenafil comes in. Sildenafil works by blocking a specific enzyme in the body called phosphodiesterase type 5 (PDE5). This enzyme normally breaks down another chemical called cyclic guanosine monophosphate (cGMP), which helps the muscles in the penis to relax and allows blood flow.

So, when you take sildenafil, it stops PDE5 from doing its job effectively. This means cGMP sticks around longer, which keeps the muscles relaxed and allows more blood to flow into the penis when you're aroused leading to a stronger, longer-lasting erection that can help you enjoy sex more easily.

How long does Sildenafil take to work?

According to clinical research by Ian Eardley and colleagues', sildenafil is an effective oral treatment for ED that generates a penetrative erection as soon as 12 minutes and for most patients, within 30 minutes of dose. One would ponder, how long does the effect of sildenafil will lasts? Well, the effect of sildenafil is known to last for a duration of at least 4 to 6 hours (4) However, the duration can vary depending on factors like metabolism, dosage and individual response.

How is Sildenafil used?

Sildenafil is available in doses of 25 mg, 50 mg, and 100 mg in the form of oral tablets/pills for ED. Individual effectiveness and tolerance dictate whether the dose needs to be increased to a maximum of 100 mg or decreased to 25 mg (2). Most patients receive a prescription of sildenafil dosage of 50 mg. Patients are recommended not to exceed a once-daily maximum dose frequency of sildenafil.

How long before sex should I use sildenafil?

Before sexual activity, take sildenafil as needed. The optimal time to take sildenafil is about 1 hour before sexual activity, although you can take it anytime between 4 hours and 30 minutes before. Sildenafil should typically be used no more than once per 24 hours (2).

What are the side effects of Sildenafil?

Let us now discuss the potential side effects of Sildenafil (Viagra):

• Headache: Like any medicine, Viagra can cause headaches in some people. However, it is typically minor.
• Flushing (Face Redness): Some people may notice their face turning red. It's similar to a transient flush that normally fades.
• Stomach pain: Viagra may cause some digestive pain, such as indigestion or a slight stomach ache.
• Dizziness: Another possible side effect is feeling lightheaded or dizzy. To avoid this, it's a good idea to rise up slowly.
• Nasal Congestion: Some patients may have stuffy or runny noses. It's not unusual.
• Muscle Aches: Muscle aches and pains are common, but they are usually transient.

The most common side effects identified in all sildenafil trials were transitory headaches (28.6%), flushing (21.9%), dizziness (8.8%), dyspepsia (6.5%), and nasal congestion (5.4%) (2). Remember that these adverse effects are not guaranteed for everyone, and many people use Viagra with no problems. If you observe anything out of the ordinary or if these side effects disturb you, consult your doctor. They're available to help and can make adjustments if necessary. It's always best to keep the lines of communication open! .

Serious side effects of sildenafil

Serious side effects are uncommon; however, they can include priapism (prolonged erection) or unexpected eyesight or hearing loss. Sildenafil has been linked to changes in colour vision, changes in light perception, and cloudy vision (5). In another study, sildenafil was linked to the condition, which causes hearing loss that may be reversible in some situations (6). Cases of sudden hearing loss or loss of hearing, occasionally accompanied by tinnitus and dizziness, associated with the use of PDE-5 inhibitors, particularly sildenafil. It is difficult to determine whether reported cases are directly related to the patient's underlying risk factors for hearing loss, the use of sildenafil, or both, or to other variables.

Sildenafil interactions with other medications

When taking sildenafil, you should be aware that it can interact with certain other drugs, potentially causing complications. For example, if you take nitrate-containing drugs for chest discomfort (such as nitroglycerin), avoid sildenafil. Sildenafil interactions with nitroglycerin can cause a considerable drop in blood pressure, which is quite dangerous.

If you use alpha-blockers for conditions such as high blood pressure, taking them with sildenafil can cause dizziness because of reduction in blood pressure.

Also, some antifungal treatments can interfere with how your body uses sildenafil, your doctor should keep an eye on things. Combining sildenafil with HIV drugs known as protease inhibitors might also produce complications. It's as if certain puzzle pieces don't fit together precisely.

Also, if you're taking other prescriptions that perform similarly to sildenafil or other erectile dysfunction medications, taking them simultaneously may cause more problems than solutions. Always inform your doctor about all medications you are taking, even those purchased without a prescription. This manner, they can ensure that everything functions properly and without causing you any problems. Never modify your prescriptions without first consulting your doctor.

Drugs you should not use with sildenafil

As explained above, you need to exercise caution when using Sildenafil with other medications, because they don’t always interact well with each other. Some examples of drug which you should never take with sildenafil are the following:

• Nitrate medications- Examples of nitrates are isosorbide mononitrate, isosorbide dinitrate, and nitroglycerin.
• Mifepristone
• Riociguat and Vericiguat
• Lefamulin and Voxelotor
• Poppers
• Anti-hypertensives and benign prostatic hyperplasia medications
• Alpha-blocker
• Protease inhibitor
• Other medications—for example, itraconazole and erythromycin

Sildenafil warnings

It is crucial to be aware of certain warnings associated with using Sildenafil. It can cause vasodilation and should be used with caution in patients who may be sensitive to such blood pressure changes. This includes individuals with left ventricular outflow blockage (patients with obstruction in and around heart valves) and impaired autonomic blood pressure control (patients with nervous dysfunction-related defects in contraction of heart muscles which causes changes in blood pressure) (6). When taking sildenafil with alpha-adrenergic blocking medicines (class of drugs for high bood pressure) or other antihypertensive medications, use it with caution (7).

Occasionally, Sildenafil can lead to a prolonged erection lasting more than 4 hours, commonly known as priapism. If left untreated, priapism can cause penile tissue damage. Additionally, sildenafil should be used with an alert in people who have physical deformations of the penis or who have illnesses that may predispose them to priapism, such as sickle cell anaemia or multiple myeloma (8).

PDE5 drugs, such as sildenafil, may raise the risk of non-arteritic anterior ischemic optic neuropathy (NAION) in men over the age of 50. Patients having a history of NAION or a "crowded" optic disk should therefore be prescribed sildenafil with caution (9).

Conclusion

Sildenafil is a proven treatment for erectile dysfunction in men. By improving blood flow to the penis, it facilitates the ability to achieve and sustain an erection. It's a sound remedy for many people with ED when used correctly and under the supervision of a doctor. However, one should be aware of any potential adverse effects along with how it interferes with other medications. Taking care of your sexual health entails more than simply taking medication; it also necessitates an open communication with your doctor and caring for your overall health. By prioritizing self-care and seeking medical guidance can help Sildenafil yield better results.