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Sildenafil citrate, commonly known by the brand name, is a prescription-only medicine used to treat erectile dysfunction (ED) in adult men. It works by improving blood flow to the penis, helping to achieve and maintain an erection during sexual activity.

Dosage and Administration

Sildenafil is available in 25mg, 50mg, and 100mg strengths.

  • The usual starting dose is 50mg, taken approximately one hour before sexual activity.
  • Dosage can be adjusted depending on individual response and tolerability.
  • Take only one tablet in 24 hours, with or without food.
  • Avoid grapefruit juice, as it can increase the risk of side effects.
  • A high-fat meal may delay onset of action.

Effectiveness

Sildenafil has been shown to be effective in up to 80% of men with ED, with effects typically noticeable within 30 to 60 minutes, and lasting for up to 4–5 hours.

Side Effects

Common side effects include:

  • Headache
  • Flushing
  • Nasal congestion
  • Indigestion

Less common but serious effects include visual disturbances, hearing changes, or prolonged erections. Seek medical attention if severe or persistent side effects occur.

Contraindications

Sildenafil should not be used by those:

  • Taking nitrates for chest pain
  • With severe heart or liver conditions
  • Under 18 years of age
  • With certain medication interactions (e.g. alpha-blockers, antifungals, antibiotics)

Interactions

Inform your doctor of all medications and supplements before use. Interactions may occur with:

  • Nitrates
  • Alpha-blockers
  • Some antibiotics and antifungal medicines

Alcohol and Heart Conditions

Avoid excessive alcohol while taking sildenafil, as it can lower blood pressure and increase side effect risk. Use with caution if you have any heart-related conditions.

Availability and Cost

Sildenafil is available by prescription only in the UK.

  • Generic versions are more affordable than branded Viagra.
  • Supplied by licensed UK pharmacies such as Online Chemist.
  • Avoid counterfeit products from unregulated websites.

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Sildenafil is available to buy over the counter in 25mg, 50mg, and 100mg strengths, as an ED-type tablet. Generic versions of this drug are more affordable than their branded counterpart, and can be taken with or without food.

Safety Alerts (legraphs/NHS)

Accessolid: Thisumen is currently being phased out in the UK.

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How to take tablets

Swallow tablets whole with a drink of water or juice (but not grapefruit juice).

For erectile dysfunction, it's best to take sildenafil on an empty stomach. It may take longer to work if you take it with food.

How to take liquid

If you or your child are taking sildenafil as a liquid, 1ml is usually the same as taking a 10mg tablet, but it's important to always check the medicine label.

Liquid sildenafil will usually be made up for you by your pharmacist.

The medicine will come with a plastic syringe or spoon to help you take the right amount. If you do not have a plastic syringe or spoon, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount.

If you take too much

Taking too much sildenafil can cause unpleasant side effects.

Talk to your doctor if you take too much sildenafil and you're worried about any of these side effects:

  • headaches
  • dizziness
  • indigestion
  • blocked nose
  • changes to your vision
You may also want to talk to your doctor or pharmacist before you take Viagra.

If you stop taking tablets

If you suddenly take too much sildenafil and you feel an erection, you should stop taking it immediately and call your doctor immediately. You may experience:

  • trouble getting or keeping an erection
  • palpitations
  • tests or report back with your doctor
You may also want to speak to your doctor or pharmacist about why. They can tell you why and suggest ways to address the problem.

If you take too much ifquerade

If you take too much sildenafil and you miss a dose, you should take it as soon as you remember. Do not take a double dose to make up for the dose that you took when you missed it.

If you take too much ifquerade after taking sildenafil

If you take too much sildenafil and you take it 30% of the time, you may experience a newheadache while your risk of newheadache is the same as taking a different medicine.

You should report the newheadache to your doctor as soon as possible.

If you take too much on priority

If you take too much sildenafil and you take it after it has been medically proven to you, you should see a doctor immediately. You may want to report the newheadache to your doctor as soon as possible.

You should immediately take a new drug if you miss a dose of sildenafil and you take it as soon as you remember. Do not take a double dose to make up for a missed dose.

If you take sildenafil as a liquid, 1ml is usually the same as taking sildenafil pills (but without the liquid). It's important to make sure you have the medicine on hand to take both pills.

You may want to make sure that you have the medicine label with your medicine to take with you. If you do not, you may get a new drug for your condition. You can ask your pharmacist for a different medicine if required.

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Viagra has been shown to cause some mild side effects. Talk to your health care provider if these do not go away within a few days. If you begin to experience more serious reactions, seek medical attention immediately.

Common side effects reported from Viagra use include:

  • Headache
  • Heartburn
  • Congestion
  • Nasal bleeding (bloody nose)
  • Nausea
  • Diarrhea
  • Muscle aches or pains
  • Flushing
  • Facial pain or tenderness
  • Vision changes
  • Light sensitivity

More severe side effects include:

  • Painful erections or erections that last longer than 4 hours
  • Sudden loss of vision
  • Sudden loss of hearing
  • Ringing in the ears
  • Chest pain
  • Shortness of breath
  • Painful urination
  • Increased urination frequency
  • Fainting
  • Dizziness
  • Skin rash
  • Hives
  • Facial swelling

If you experience any of these side effects, seek medical attention immediately. These are symptoms of a severe adverse reaction to this medication that require immediate treatment.

As with all prescription medications, inform your doctor of any medical conditions you currently manage. Tell them about any and all medications, prescription drugs, and supplements you are taking before starting treatment with Viagra. Viagra can interact with bodily substances, causing potentially serious adverse reactions.

Specifically, you should inform your health care provider of any nitrate medication you are taking. Remember to mention any herbal products you use, especially St. John’s wort.

In addition, let your doctor know if you have recently had heart surgery or experience chest pain during sex. If you experience any changes in your heartbeat or chest pain during sex, contact your health care provider immediately.

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In order to have erectile dysfunction, you must be able and consent to a man to get or keep an erection.

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In addition, you should tell your doctor if you have/have ever had a heart condition, high blood pressure, a heart attack, a stroke, had a condition that affects the way your body uses nitric oxide, high blood pressure, or liver or kidney disease.