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Many men suffering erectile dysfunction and prescribed oral treatment, such as Viagra, experience side effects including dizziness, severe headaches and blurred vision. The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline. Viagra belongs to the substance group of selective phosphodiesterase inhibitors and develops its effect by directly promoting blood circulation in the Penis.
VIAGRA®, an oral therapy for erectile dysfunction, is the citrate salt of sildenafil, a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). Mechanism of Action The physiologic mechanism of erection of the penis involves release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. In addition to human corpus cavernosum smooth muscle, PDE5 is also found in lower concentrations in other tissues including platelets, vascular and visceral smooth muscle, and skeletal muscle. Pharmacokinetics and Metabolism VIAGRA is rapidly absorbed after oral administration, with absolute bioavailability of about 40%. Based upon measurements of sildenafil in semen of healthy volunteers 90 minutes after dosing, less than 0.001% of the administered dose may appear in the semen of patients.
Metabolism and Excretion: Sildenafil is cleared predominantly by the CYP3A4 (major route) and CYP2C9 (minor route) hepatic microsomal isoenzymes. After either oral or intravenous administration, sildenafil is excreted as metabolites predominantly in the feces (approximately 80% of administered oral dose) and to a lesser extent in the urine (approximately 13% of the administered oral dose).
As noted above (How Sex Affects the Body), ask your doctor if your heart is healthy enough for sexual activity. If you take any medicines that contain nitrates - either regularly or as needed - you should never take VIAGRA. VIAGRA does not protect you or your partner from getting sexually transmitted diseases, including HIV-the virus that causes AIDS. Remember, VIAGRA should never be used with medicines that contain nitrates (see VIAGRA Is Not for Everyone).
If you are taking alpha-blocker therapy for the treatment of high blood pressure or prostate problems, you should not take a dose of greater than 25 mg of VIAGRA at the same time (within 4 hours) as you take your dose of alpha-blocker. If you are taking a protease inhibitor, your dose may be adjusted (please see Finding the Right Dose for You). If you are older than age 65, or have serious liver or kidney problems, your doctor may start you at the lowest dose (25 mg) of VIAGRA. Heart attack, stroke, irregular heart beats, and death have been reported rarely in men taking VIAGRA. Viagra Ice Cream Arouses Consumers With 25Mg Per Scoop: Ice Cream To Treat Erectile Dysfunction? What is Erectile Dysfunction?Erectile dysfunction (ED) is the repeated inability to achieve or maintain an erection sufficient for satisfactory sexual performance1. Featured Blog PostWhen a woman with a sex problemWhen a woman with a sex problem sits down with a doctor or sex expert, they're up against centuries of sexist stereotypes—and a raging debate about how to undo those stereotypes. Men in the UK are the first in the world to have access to the new cream, which contains the drug alprostadil.



However the majority of those men, 68 per cent, continued with their treatment just so they can continue to achieve an erection.As the cream is applied directly to the genitals these generalised side effects are considered unlikey, experts say. It works by dilating blood vessels in the penis, allowing the inflow of blood needed for an erection. VIAGRA (sildenafil citrate) is formulated as blue, film-coated rounded-diamond-shaped tablets equivalent to 25 mg, 50 mg and 100 mg of sildenafil for oral administration.
NO then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate (cGMP), producing smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood. The inhibition of PDE5 in these tissues by sildenafil may be the basis for the enhanced platelet antiaggregatory activity of nitric oxide observed in vitro, an inhibition of platelet thrombus formation in vivo and peripheral arterial-venous dilatation in vivo. Maximum observed plasma concentrations are reached within 30 to 120 minutes (median 60 minutes) of oral dosing in the fasted state.
The major circulating metabolite results from N-desmethylation of sildenafil, and is itself further metabolized. Similar values for pharmacokinetic parameters were seen in normal volunteers and in the patient population, using a population pharmacokinetic approach.
It can help many men who have erectile dysfunction get and keep an erection when they become sexually excited (stimulated). VIAGRA helps a man with erectile dysfunction get an erection only when he is sexually excited.
When a man is sexually excited, VIAGRA helps the penis fill with enough blood to cause an erection. If you take VIAGRA with any nitrate medicine or recreational drug containing nitrates, your blood pressure could suddenly drop to an unsafe level. If you are not sure if any of your medicines contain nitrates, or if you do not understand what nitrates are, ask your doctor or pharmacist.
These treatments include pills, medicines that are injected or inserted into the penis, implants or vacuum pumps.
If you are taking protease inhibitors, such as for the treatment of HIV, your doctor may recommend a 25 mg dose and may limit you to a maximum single dose of 25 mg of VIAGRA in a 48 hour period. Beginning in about 30 minutes and for up to 4 hours, VIAGRA can help you get an erection if you are sexually excited. You should call a doctor immediately if you ever have an erection that lasts more than 4 hours. If you want more information or develop any side effects or symptoms you are concerned about, call your doctor.
It occurs in 15 to 30 million men in the United States.  Incidence of ED increases with age but can be successfully treated. Sildenafil has no direct relaxant effect on isolated human corpus cavernosum, but enhances the effect of nitric oxide (NO) by inhibiting phosphodiesterase type 5 (PDE5), which is responsible for degradation of cGMP in the corpus cavernosum.
The approximately 4,000-fold selectivity for PDE5 versus PDE3 is important because PDE3 is involved in control of cardiac contractility.
It is eliminated predominantly by hepatic metabolism (mainly cytochrome P450 3A4) and is converted to an active metabolite with properties similar to the parent, sildenafil.


When VIAGRA is taken with a high fat meal, the rate of absorption is reduced, with a mean delay in Tmax of 60 minutes and a mean reduction in Cmax of 29%.
This metabolite has a PDE selectivity profile similar to sildenafil and an in vitro potency for PDE5 approximately 50% of the parent drug. Before you start any treatment for erectile dysfunction, ask your doctor if your heart is healthy enough to handle the extra strain of having sex. You will need to have a thorough medical exam to diagnose your erectile dysfunction and to find out if you can safely take VIAGRA alone or with your other medicines.
If you are taking alpha-blocker therapy, you should not take a dose of greater than 25 mg of VIAGRA at the same time (within 4 hours) as your dose of alpha-blocker. If you take VIAGRA after a high-fat meal (such as a cheeseburger and french fries), the medicine may take a little longer to start working. In the UK, you can visit the public health service's NHS Direct site for "a comprehensive on-line health encyclopaedia". When sexual stimulation causes local release of NO, 2 inhibition of PDE5 by sildenafil causes increased levels of cGMP in the corpus cavernosum, resulting in smooth muscle relaxation and inflow of blood to the corpus cavernosum. Sildenafil is only about 10-fold as potent for PDE5 compared to PDE6, an enzyme found in the retina which is involved in the phototransduction pathway of the retina. The mean steady state volume of distribution (Vss) for sildenafil is 105 L, indicating distribution into the issues. Plasma concentrations of this metabolite are approximately 40% of those seen for sildenafil, so that the metabolite accounts for about 20% of sildenafil's pharmacologic effects. After the man is done having sex, this extra blood flows out of the penis back into the body. If you have chest pains, dizziness or nausea during sex, stop having sex and immediately tell your doctor you have had this problem. Your doctor should determine if your heart is healthy enough to handle the extra strain of having sex. The most common side effects of VIAGRA are headache, flushing of the face, and upset stomach. This lower selectivity is thought to be the basis for abnormalities related to color vision observed with higher doses or plasma levels (see Pharmacodynamics). Sildenafil and its major circulating N-desmethyl metabolite are both approximately 96% bound to plasma proteins. 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. If an erection lasts for a long time (more than 6 hours), it can permanently damage your penis. You should call a doctor immediately if you ever have a prolonged erection that lasts more than 4 hours.



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