VIAGRA (sildenafil citrate)

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(sildenafil) relaxes muscles found in the walls of blood vessels and increases blood flow to particular areas of the body.

Viagra is used to treat erectile dysfunction (impotence) in men. Another brand of sildenafil is Revatio, which is used to treat pulmonary arterial hypertension and improve exercise capacity in men and women. This page contains specific information for Viagra, not Revatio.

Do not take Viagra while also taking Revatio, unless your doctor tells you to.

Important information

Some medicines can cause unwanted or dangerous effects when used with Viagra. Tell your doctor about all your current medicines, especially riociguat (Adempas) and nitrates.

Do not take Viagra if you are also using a nitrate drug for chest pain or heart problems, including nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, and some recreational drugs such as “poppers”. Taking sildenafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure.

Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours. A prolonged erection (priapism) can damage the penis.

Stop using Viagra and get emergency medical help if you have sudden vision loss.

Before taking this medicine

You should not use Viagra if you are allergic to sildenafil, or:

  • if you take other medicines to treat pulmonary arterial hypertension, such as riociguat (Adempas).
  • if you take nitrates.

Do not take Viagra if you are also using a nitrate drug for chest pain or heart problems. This includes nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite (“poppers”). Taking sildenafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure.

To make sure Viagra is safe for you, tell your doctor if you have ever had:

  • heart disease or heart rhythm problems, coronary artery disease;
  • a heart attack, stroke, or congestive heart failure;
  • high or low blood pressure;
  • liver or kidney disease;
  • a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia;
  • a bleeding disorder such as hemophilia;
  • a stomach ulcer;
  • retinitis pigmentosa (an inherited condition of the eye);
  • a physical deformity of the penis (such as Peyronie’s disease); or
  • if you have been told you should not have sexual intercourse for health reasons.

Viagra can decrease blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking sildenafil, most of whom also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoked or were over 50 years old. It is not clear whether sildenafil is the actual cause of vision loss.

Viagra is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether sildenafil passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Do not give this medicine to anyone under 18 years old without medical advice.

How should I take Viagra?

Take Viagra exactly as it was prescribed for you. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Viagra is usually taken only when needed, 30 minutes to 1 hour before sexual activity. You may take it up to 4 hours before sexual activity. Do not take Viagra more than once per day.

Viagra can help you have an erection when sexual stimulation occurs. An erection will not occur just by taking a pill. Follow your doctor’s instructions.

During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect of sildenafil.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Since Viagra is used as needed, you are not likely to miss a dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Viagra?

Drinking alcohol with this medicine can cause side effects.

Grapefruit and grapefruit juice may interact with sildenafil and lead to unwanted side effects. Avoid the use of grapefruit products while taking sildenafil.

Avoid using any other medicines to treat impotence, such as alprostadil or yohimbine, without first talking to your doctor.

Viagra side effects

Get emergency medical help if you have signs of an allergic reaction to Viagra: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking Viagra and get emergency medical help if you have:

  • heart attack symptoms–chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;
  • vision changes or sudden vision loss; or
  • erection is painful or lasts longer than 4 hours (prolonged erection can damage the penis).

Call your doctor at once if you have:

  • ringing in your ears, or sudden hearing loss;
  • irregular heartbeat;
  • swelling in your hands, ankles, or feet;
  • shortness of breath;
  • seizure (convulsions); or
  • a light-headed feeling, like you might pass out.
  • flushing (warmth, redness, or tingly feeling);
  • headache, dizziness;
  • abnormal vision (blurred vision, changes in color vision)
  • runny or stuffy nose, nosebleeds;
  • sleep problems (insomnia);
  • muscle pain, back pain; or
  • upset stomach.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Viagra?

Do not take Viagra with similar medications such as avanafil (Stendra), tadalafil (Cialis) or vardenafil (Levitra). Tell your doctor about all other medications you use for erectile dysfunction.

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • drugs to treat high blood pressure or a prostate disorder;
  • an antibiotic – clarithromycin, erythromycin, or telithromycin;
  • antifungal medicine – ketoconazole or itraconazole; or
  • medicine to treat HIV/AIDS – atazanavir, indinavir, ritonavir, or saquinavir;
  • nitrates;
  • medications used to treat pulmonary artery hypertension.

This list is not complete. Other drugs may interact with sildenafil, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

How Long Does Viagra Last?

Sildenafil is a common medication used to stimulate erections in men with erectile dysfunction (ED) and treat pulmonary arterial hypertension (high blood pressure affecting the lungs and heart).

For treating ED specifically, Viagra is the well-known brand-name version of this drug.

Many factors can influence how long Viagra takes to start working. In general, Viagra takes about 30 minutes to produce noticeable effects.

But your diet, your overall health, the medications you’re taking, underlying conditions, and much more can all affect the amount of time Viagra takes to work in your body and how long it lasts.

How does it work?

An erection happens when nerves in your penis are stimulated.

As a result, muscles around two cylinder-shaped chambers of spongy material along your penis, known as the corpus cavernosa, relax and allow blood to flow in, causing an erection.

With ED, your nerves don’t communicate properly with your brain and blood doesn’t flow properly into the corpus cavernosa. Taking Viagra relaxes the walls of your blood vessels and lets blood flow more easily into the parts of your penis that cause an erection.

How long does it take to start working?

Viagra normally starts working 30 to 60 minutes after you take it in oral tablet form. It may take up to 2 hours to work.

Viagra doesn’t work on its own. You’ll still need to feel sexually aroused to get an erection. Feeling relaxed and comfortable can also help Viagra take effect sooner.

How long does it last?

On average, Viagra usually lasts between 2 and 3 hours before its effects start to diminish. Viagra can last up to 5 hours or longer depending on your dosage, your body’s metabolism, and other external factors.

Depending on how your body metabolizes it, you may be able to get an erection several times with Viagra in your body. Viagra probably won’t make you last longer in bed, though. No research has proven definitively that Viagra can increase how long you can have sex.

Viagra may not work again immediately after you’ve had sex. Normally, you can’t get another erection right after ejaculating because your body isn’t physically prepared for it.

This is known as the refractory period. It may only last a few minutes, but it can last as long as a few hours or days. However, a 2000 studyTrusted Source found that Viagra may decrease this recovery time.

Can any factors affect how long it lasts?

Several important factors can influence how long Viagra lasts for you:

  • Dosage. The amount of Viagra you take affects how long it stays in your system. The smallest available dose, 25 milligrams (mg), won’t last as long as the largest available dose, 100 mg. But taking a higher dose isn’t always recommended, as it may not be safe for you.
  • Age. As you get older, your metabolism slows down. So Viagra may last longer as you age. In general, you may notice Viagra works for a longer period when you’re 65 or older.
  • Diet and lifestyle. Eating a large meal or a lot of high-fat foods right before you take Viagra can keep it from being metabolized quickly or effectively. But this can also make it last longer as it’s metabolized along with your meal. Drinking alcohol or smoking can also decrease blood flow to your penis, making Viagra less effective or shorter-lasting.
  • Medications. Some medications, especially antibiotics such as erythromycin (Ery-Tab), clarithromycin (Biaxin), and ciprofloxacin (Cipro), can interact with Viagra and affect how long it lasts.
  • Overall health. Certain existing conditions can affect how long Viagra lasts and how well it works for you. Diabetes, nervous system conditions like multiple sclerosis (MS), and heart conditions like atherosclerosis (fat buildup in your blood vessels) can all make Viagra less effective and not last as long. Some kidney conditions may make Viagra last longer because of the condition’s effect on your metabolism.
  • Psychological state. Feeling anxious, nervous, depressed, or stressed can all influence how your body responds to sexual stimulation. If you’re not relaxed or comfortable during sex, or if you have performance anxiety because of past sexual experiences, Viagra may not last long or be fully effective.

How long does it take to leave my system?

Viagra usually leaves your system after 2 to 3 hours. Depending on your metabolism, Viagra can take 5 to 6 hours to fully leave your system.

A higher dosage will take longer to leave your body. A 25-mg dose may wear off after a couple of hours, but a 100-mg dose may take nearly four times as long to leave your system.

Is there anything I should be concerned about?

Viagra often lasts for a few hours. You won’t normally have an erection the entire time, as Viagra is only used to help increase blood flow. If you don’t think Viagra is working fast enough, try masturbation or foreplay to help stimulate arousal.

If Viagra doesn’t work after 30 minutes, don’t take any more than the daily dose that your doctor prescribed. Never take more than 100 mg of Viagra in a 24-hour period.

Taking too much Viagra can cause priapism, a painful erection that lasts longer than 4 hours. This can damage penis tissue because blood stored in the penis isn’t receiving any oxygen. Get emergency treatment right away if this happens.

When to see your doctor

Talk to your doctor before you take Viagra or any related medication for ED. It’s important to take a safe dose and work out a clear understanding of how much you should take in a 24-hour period.

Some medications for heart conditions, such as nitroglycerin and other nitrates, can interact dangerously with Viagra and cause your blood pressure to drop too low.

If Viagra isn’t working or isn’t safe for you, talk to your doctor about other possible treatments for ED, such as:

    • penis pumps
    • penile implants
    • exercises
    • therapy for anxiety, depression, or other similar conditions