How Does Food Affect The Action Of Viagra And Sildenafil?

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The Relationship Between Food and Viagra

viagra-pfizer-100mg-4-tablets_2According to the Massachusetts Male Ageing Study, around 52% of males will be affected with some degree of Erectile Dysfunction between the ages of 40 and 70 years old. However, in spite of this relatively high prevalence, there is still quite a high degree of social stigma attached to this particular ailment, with it being the punchline to many jokes. Erectile dysfunction is not something to be embarrassed or joked about. Ultimately it is a physiological disorder with the reproductive system in the same way that diverticulitis is a physiological disorder of the GI tract! What’s funny about that?

Erectile dysfunction can be a subject of great shame for the men concerned, it may make them feel less masculine and it can also cause marital problems. Luckily there are a number of treatment options available- one of which is known as sildenafil, or more commonly Viagra. Viagra is a drug that works by affecting the width of blood vessels in the body. It works by increasing the ease with which blood can enter the penis, allowing development and maintenance of an erection. It does this by ‘relaxing’ the blood vessels, making them wider and allowing greater ease of blood flow into the penis, allowing the tissue to expand and harden. For illustrative purposes think of the blood being represented by tomato ketchup, and blood vessels being represented by a straw (without the use of Viagra) or a toilet roll tube (with the use of Viagra). From this illustration it is clear to see that the tomato ketchup will enter the toilet roll tube with greater ease than entering the straw; the same is true in the body.

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The action of Viagra can be extremely variable, however, this is rarely due to the action of the drug itself. Instead, this variability is often due to how the individual patient takes the medication. There are a number of factors can affect the action of Viagra in the body, the most surprising of these being food and drink! I bet you didn’t know that! Luckily, that is why I am here; I am here to tell you all about how the food and drink that you eat can affect the efficacy of Viagra. There are four key pieces of information that every man taking Viagra needs to know in order to get the most out of their medicine!

 

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Product Description

How does Viagra and Sildenafil work?

Viagra (Sildenafil) helps men to get and maintain an erection when sexually stimulated and/or excited. The medicine relaxes the blood vessels in the penis which results in more blood flowing to the penis when you are sexually excited.

How do I take it?

You should take Viagra (Sildenafil) approximately 1 hour before planning to have intercourse. Within a window of between 30 minutes and 4 hours after you take the medicine, it will be easier to keep and maintain an erection when you are sexually excited. If you take this medicine after a meal with a high fat content it may take a little longer to start working. This medicine will only work when you are sexually excited. You won’t get an erection just by taking Viagra (Sildenafil).

Dosage

The standard recommended dose for Viagra (Sildenafil) is 50mg and this will be suitable for most people.  If this dose is not effective, you can try 100mg and if 50mg gives you side effects you can also reduce the dose to 25mg tablets.

You must not take more than 100mg daily of Sildenafil/ Viagra. Clinical trials have been conducted in patients taking up to 200mg sildenafil and it was found that ‘doses of 200mg did not result in increased efficacy but did increase the incidence of adverse reactions (headache, flushing, dizziness, dyspepsia, nasal congestion, and altered vision).’

In addition, in patients taking more than 100mg daily, there have been reports of rhabdomyolysis (a breakdown in skeletal muscle tissue the byproducts of which can lead to kidney failure), visual perception changes, vertebral artery dissection (a tear in the artery supplying blood to the brain), heart attacks and aggressive behaviour.

If the 100mg strength doesn’t work for you, there may be alternatives you can try and we recommend that you call us for a free consultation with our pharmacist or doctor to discuss any underlying conditions you may have. We recommend that all men taking medicine for erectile dysfunction have regular tests for blood pressure, cholesterol, diabetes and hormone imbalances. For instance, it may be that by fixing a hormone imbalance such as testosterone, your Viagra medication will be even more effective.

In addition, drug manufacturers do not advise patients to split tablets in half to get the correct dosage as they cannot guarantee that the active ingredient will be distributed evenly throughout the tablet.  For instance, if you cut a 100mg tablet in two, you may find that you get 80mg in one half of the tablet and 20mg in the other half leading to either an overdose (increased risk of side effects) or a suboptimal dose (the medication may not work).

It is important that you choose the correct dose for you. If you wish to talk to our pharmacist or doctor about this, please contact us in the pharmacy on 01625 460621 or email [email protected]

Side Effects

Viagra (Sildenafil) is normally well tolerated, however, side effects can include:

  • Headache
  • Dizziness
  • Nausea

Side effects normally subside after a few hours, however, if you experience a prolonged or painful erection (longer than 4 hours), then you must contact your doctor immediately.

Drug interactions

There are a number of medicines which interact with Sildenafil/ Viagra. For an exhaustive list please see the patient information leaflet (see section below) or call us in the pharmacy to discuss your specific situation. The main drug interactions are listed here:

Recreational drugs such as ‘poppers’ or amyl nitrate
Alpha blockers used for urinary retention or blood pressure problems (eg Flomax or Cardura)
Anti- arrhythmic drugs such as disopyramide
Antibiotics such as erythromycin
Antifungals such as itraconazole
Antivirals such as drugs used to treat HIV
Bosentan
Cobicistat
Calcium channel blockers to treat blood pressure and angina such as amlodipine
Dapoxetine (Priligy – used to treat premature ejaculation)
Grapefruit juice**
Nicorandil
Nitrates
Riociguat
Cimetidine (to treat stomach ulcers)

Please do not take Sildenafil/Viagra if you have taken any of the above drugs within the last 60 days without first consulting with either us in the Pharmacy ([email protected] / 01625 460621) or via email with our doctor [email protected]

**We advise not to take Sildenafil/Viagra with grapefruit juice as the blood concentration of Sildenafil will possibly be increased resulting in side effects.

Patient Information Leaflets

Please click here for the patient information leaflet for Viagra.

For Actavis Sildenafil please see the following leaflets: 100mg, 50mg, 25mg.

Storing Medicines Safely

Please keep your medicine out of the reach of children and store at room temperature.  Unwanted medicine can be disposed of by returning it to any local pharmacy or indeed to us here for us to dispose of it for you.

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                                            Timing is key

Timing is KeyViagra should be taken one hour before intercourse is planned. This theory behind this time delay is that it allows the medicine time to take action. Ideally, Viagra should be taken on an empty stomach. If Viagra is taken after a meal, particularly those which are rich in fats, then it may take longer for the medicine to work. The reason for this, without getting into the heavy science behind it, is that in order for a drug to have its effect it must be first absorbed from the stomach or intestine into the bloodstream; Only when it reaches the bloodstream will it be carried to the relevant part of the body and take action. If the tablet is taken after a heavy meal, it will effectively have to ‘queue’ whilst your tummy is busy digesting the meal, and this will delay absorption and thus the action of Viagra.

Avoid Grapefruit

GrapefruitGrapefruit and grapefruit juice are very significant in terms of how they affect the action of all drugs – including Viagra. While Viagra, taken with grapefruit or grapefruit juice, will still take the action of widening blood vessels and allowing development and maintenance of an erection, grapefruit has been found guilty of preventing the breakdown of the drug in the body and allowing greater uptake of the drug from the gut into the blood. This has the somewhat undesirable impact of increasing side effect presentation of the drug. This can include; flushing of the skin, headaches, low blood pressure and the potential of fainting; all of which would make the experience of intercourse decidedly less enjoyable – nothing says; ‘I’m not in the mood,’ quite like fainting during the deed! Therefore, any change (both an increase or decrease) in the amount of grapefruit in your diet should not be made without first consulting your doctor.

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                                                                       Avoid Alcohol

Avoid AlcoholAs with all drugs, the action of Viagra can be affected through the consumption of alcohol. As mentioned above the side effects of Viagra include low blood pressure, headaches, dizziness etc. The use of alcohol alongside Viagra can increase the intensity of these side effects due to the fact that alcohol has similar effects. Alcohol can further increase the drop in blood pressure associated with the use of Viagra which may lead to increased dizziness and a heightened risk of fainting. In addition to this, the combination of these drugs may also increase the likelihood of heart palpitations. This is when the heart beats irregularly, too quickly or too slowly. This may lead to unnecessary strain being placed on the heart and vascular system and therefore the combination of the two drugs (alcohol and Viagra) should be avoided in the best interests of the individual.

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Relax and Enjoy

RelaxIt seems like a silly thing to say, but many cases of erectile dysfunction are related to psychological issues such as depression and anxiety. Erectile dysfunction in itself can cause anxiety which can then affect libido and ability to gain and maintain an erection. This results in a vicious circle of events. This anxiety can affect the ability of Viagra to bring about an erection. Whilst Viagra will still widen blood vessels regardless of psychological events, if you are not relaxed and enjoying the experience then the drug may not bring about the desired effects. Arousal is still a vital component of the process. Viagra in itself will not bring about an erection but rather will allow one to occur more effectively when aroused! The best advice I can give is to take the drug, forget all about it and enjoy the intimacy with your partner – by doing this, the Viagra should do its job – leaving you free to enjoy yourself!
 

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References:

British National Formulary; 68th Edition (2014) British Medical Association and Royal Pharmaceutical Society of Great Britain, London

http://www.drugs.com/food-interactions/sildenafil,viagra.html (accessed: 24/10/14)

http://www.health.harvard.edu/fhg/updates/update0206d.shtml (accessed 24/10/14)

http://www.nhs.uk/Conditions/Erectile-dysfunction/Pages/Causes.aspx (accessed 24/10/14)

Massachusetts Male Ageing Study 2007 (accessed 24/10/14)

 

Assured Pharmacy is not liable for the currency or accuracy of the information contained in this blog post. For specific information about your personal medical condition, please contact our doctors or pharmacists for advice on [email protected].