Important Information On The Side Effects of Viagra

Posted by Pharmacist
Aug.20, 2015
Viagra Blogs

We’ve written before about the side effects of viagra/sildenafil, but for this article, we thought we would go into more detail. Side effects can be a deal-breaker in taking any medication. This is because bad side effects can impair our everyday lives causing us undue pain, discomfort and inconvenience, and this simply isn’t good enough and so many users start to question whether the pros outweigh the cons, ergo many patients stop taking their medication and continue to suffer the symptoms. This scenario is neither good for the clinician or the patient. But what can you expect from Viagra?

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What Are The Side Effects

Viagra BlogFirst of all, it is important to acknowledge that, unfortunately, all medications including simple multivitamins have side effects and that Viagra is no exception to this. The following information looks at the clinical data concerning Viagra’s side effects allowing readers to get a feel for what users of Viagra generally experience while on this medication, therefore, enabling them to make a more informed decision on taking this treatment.

According to official product literature produced by the manufacturers of Viagra, the most common reported side effects were flushing, headache, nasal congestion and nausea.
Looking at the very specifics of research conducted in this field we can consider the previous clinical trials which have been conducted.
One initial trial to consider involved 9570 patients, executed over 74 double-blind placebo-controlled experiments. These results have been gathered over a ten year period and can be summarised by the following table:

Table 1: A table compiling the side effects of Viagra in regards to frequency

Frequency Typical Symptom(s)
Very common: side effects affecting more than one in ten participants a headache
Common: side effects affecting around one in ten participants Nausea, facial flushing, hot flushes (symptoms include a sudden feeling of heat in your upper body), indigestion and stuffy nose
Uncommon: side effects may affect one in every one hundred participants Vomiting, skin rash, light sensitivity, watery eyes, muscle pain, dry mouth, feeling hot and, or, sleepy
Rare: side effects may affect one in every one thousand participants Fainting, feeling tightness in the throat, feeling irritable, pupil dilation in the eye, dry nose and nasal congestion

 

Frequency of Side Effects

Other studies relating to the side effects of Viagra have looked at the frequency of side effects in relation to incidence and severity of side effects.Safe-Viagra-Sildenafil-In-Your-hands
In these fixed-dose studies, in which participants took a set dose of 25 mg, 50mg, 100mg or a placebo, it appeared that the sum of adverse reactions increased with higher doses. Results of this study have been summarised below.

 

Table 2 A table showing the adverse reactions reported for ≥2% of Patients (number of patients =n) treated with Viagra on a fixed-dose regime compared to a Placebo

Observed Adverse Reaction Dose of Viagra
25mg
(n=312)		 50mg
(n=511)		 100mg
(n=506)		 Placebo(n=607)
Headache 16% 21% 28% 7%
Flushing 10% 19% 18% 2%
Nasal congestion 4% 4% 9% 2%
Back Pain 3% 4% 4% 2%
Nausea 2% 3% 3% 1%
Dizziness 3% 4% 3% 1%
Rash 1% 2% 3% 1%

 

It is important for readers at this point to take note that Viagra is not recommended to be taken as a fixed dose regime medication but rather as a flexible dose treatment. In a flexible-dose system, a patient would take Viagra on an ‘as required’ basis following direction from the doctor or other healthcare providers. Typically, patients taking Viagra the recommended dose is 50mg daily and should be taken with a glass of water. This is a starting dose and is generally amended on a per patient basis to suit their individual needs, for example, if the erection was not sufficiently rigid for the desired or necessary length of time then the dose would be increased.

 

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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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Related products

 

In a subsequent study, Viagra was taken on a flexible regime of ‘take a tablet as needed’ basis and in which doses were tailored on an individual needs basis, over a duration of 26 weeks in which all participants took Viagra at least once a week. The following results were observed:

Table 3A table showing the adverse reactions reported for ≥2% of Patients (number of patients =n) treated with Viagra on a flexible dose regime compared to a Placebo

Observed Adverse Reaction Viagra(n=734) Placebo(n=725)
A headache 16% 4%
Flushing 10% 1%
Nasal congestion 4% 2%
Back Pain 2% 2%
Dizziness 2% 1%
Rash 2% 1%

 

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As can be seen, by the information above, it is much more beneficial for patients to take Viagra as a flexible dose basis in accordance with advice from the healthcare professional. Following this advice has resulted in a reduction in the adverse side effects experienced by patients compared to those in a fixed dose regime study, as discussed above.

Furthermore, post-marketing surveying related to angina (a heart condition) have been rare and mostly occur in men who had a pre-existing heart problem and, therefore, it is not possible to determine whether these side effects were directly related to the use of Viagra or not.

Likelyhood of Side Effects

Sildenafil-100-4A final study to consider is that comparing how likely the side effects of Viagra are in making patients stop using the medication. In a placebo-controlled study, Viagra was administered to 3700 patients aged between 19 to 87 years old. The duration of this study lasted one year, after which patients were asked whether they had stopped taking Viagra on the basis solely of adverse side effects. Of the 3700 patients, only 2.5% discontinued treatment. This is especially significant considering that 2.3% of patients taking a placebo medication had ceased treatment due to side effects. Therefore, only a tiny margin of 0.2% of volunteers has to stop Viagra due to adverse reactions as compared to the drug-free placebo.

If you experience any of the symptoms listed above or any other abnormal signs/ feelings, don’t delay in seeking professional advice. Furthermore, for information on dosing the regime of Viagra medication patients should also seek the aid of a trained professional who will be able to answer any questions you may have.

Conclusion

In conclusion, the side effects of Viagra do definitely exist and that really is the hard truth. However, they are generally mild in terms of severity and frequency. Clinical data, as listed above, has shown that although these adverse reactions do exist, very few users actually stop treatment, perhaps indicating that in this case, the pros do outweigh the cons. For information on how well Viagra works as well as much more information see the rest of our blog; you too may soon discover the benefits of Viagra.

 

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References:

 

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].