Is Viagra/Sildenafil Safe?

sildenafil-actavis-100mg-4-tablets_1“Is it safe?” the question asked by so many before taking a new medication.

Unfortunately, there is no straight yes or no answer to this sort of question. Whilst the manufacturing process of all drugs is tightly regulated and controlled in order to control risks, there is little that the industry can do to predict how each individual will respond to a medicine. For this reason, there is always some degree of risk when taking a medication and Viagra is no exception. Add to this improper use of the medication by a patient either intentionally or by mistake and the risk for detrimental side-effects from Viagra use rises yet further.

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Within manufacturing, quality control measures are in place to ensure that the drug is what it says it is, that the correct amount of drug is present in each individual capsule and that both the active pharmaceutical ingredient (drug) and the excipients (other compounds used in production of a tablet, other than the drug) have limited contamination with potentially harmful impurities or micro-organisms. All of these standards that must be met are set out in the British Pharmacopoeia and should be followed by law. All legitimate drug companies will produce medications to these standards in an attempt to reduce the risk of harm to the patients. In addition to this, the pharma companies are also required by law to produce an in-depth patient information leaflet to inform patients on how to use the medication, when to avoid taking the medication and usual and unusual side effects associated with the medication.

It is important to note that these standards are only enforced on legally operating pharmaceutical companies, this, therefore, means that safety of all medications, not just Viagra, depends on how the patient uses the medication including compliance with instructions for use, only taking the medicine when required and other medications that the patient is taking. Safety of medicines is also dependent on the genetic disposition of the patient which can affect things such as allergic responses and metabolism and excretion of drug substances.

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Viagra & Generic Sildenafil

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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.

51 reviews for Viagra & Generic Sildenafil

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    Great service & a great price the best online pharmacy I have used

    • Robbie Toan

      Thanks Robert for your kind comments, Robbie Toan

  2. David

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  3. Philip

    Generic tablets work well, highly professional service.

  4. MELVIN

    This is my first order with Assuredpharmacy and I am very pleased with all processes involved with my purchase. I found the web site clear and easy to use, the prices very competitive, the prescription service very convenient and and efficient, and delivery was “super” quick. I will be using Assuredpharmacy again in the future.

  5. Doug

    Only used one as yet did the same as viagra, At last value for money

  6. Sherwan

    I will order from here in the future, discreet, friendly service and the cheapest on the internet. Also gave me a discount which I can use in the future when ever I want which I will and I’m happy about.

  7. David

    Professional service. Discreet packaging and speedy delivery.

  8. John

    fast service, generic worked a treat

  9. Christopher

    impressed with the fast reliable service of AP – the generic worked perfectly – thanks

  10. frank

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Genetic Disposition:

  1. Allergies:

Allergic reaction to viagraSome patients may possess a particular genetic makeup which causes them to be sensitive to Sildenafil which is the drug found in branded Viagra. This causes an allergic reaction caused by the immune system over-reacting to the presence of the Viagra.

Generally, in these people, Viagra is taken in and is detected in the body by an immune system antibody known as Immunoglobin E. This antibody acts on other immune system cells stimulating the release of inflammatory mediators. It is these mediators that bring about the classic symptoms of an allergic reaction. In some individuals, the resulting symptoms may be mild, and little more than uncomfortable for the patient, however in other cases the response can be extremely severe and even life-threatening. The inflammatory mediators released can act on tissues in the body causing them to swell in an attempt to contain the foreign particle, in this case, Viagra. This inflammation and swelling can lead to shortness of breath, difficulty breathing, changes in heart rate and many more effects. If severe enough this reaction may be fatal.

Whilst severe allergic reactions to this drug are rare, it is for obvious reasons that those individuals with a known sensitivity to Viagra or any of the other ingredients present in the medication should not be given it.

  1. Genes controlling metabolism and excretion of the drug:

GenesWithin the body, a group of enzymes known as Cytochrome P450 enzymes are responsible for the breakdown of most drugs that enter the body. Viagra is no exception to this. It is broken down by the enzyme CYP3A4. The proportion of this enzyme in an individual can also affect the safety of Viagra in the body. In the majority of the population, two copies of the gene responsible for the production of CY3A4 are present. This is the standard on which recommended doses of Viagra are based. However, in some members of the population, only one copy of this gene may be present. This means that the breakdown of the drug is much slower than in those with full CYP3A4 function. This can lead to the build-up of Viagra in the blood which may lead to an overdose. This can be unsafe for the patient as it can lead to irregular heartbeat, chest pains, painful prolonged erections etc. Immediate medical help should be sought if an overdose is suspected in order to reduce the risk of permanent effects. Due to the potentially serious results of an overdose, those who are slow to break down Viagra should be monitored carefully or prescribed an alternative. Again, in the majority of people this will not be an issue but due to the seriousness of the potential outcome, it should be noted.

Patient Compliance:

Viagra is a medication which is subject to some level of abuse. In recent years, it has been reported that more and more men not suffering from erectile dysfunction are using Viagra. This is due to the fact that the medication in healthy individuals can bring about a larger and more prolonged erection. This is not safe & can lead to the individual developing erectile dysfunction as a result. The safety of Viagra in healthy individuals is not known and therefore the use of the medicine when not necessary should be discouraged.

assured-pharmacy-logoFor those men who genuinely are suffering from erectile dysfunction and therefore do require the medication, there are a few things which you can avoid in order to make the use of the medicine as safe as possible. Firstly, it is important to ensure that you purchase Viagra from a reliable source ( such as Assured Pharmacy!) as this ensures that the products have been subjected to rigorous quality control procedures before reaching the market. Buying from a less reliable source may increase risk as these quality control measures will not have been in place and there is a possibility that it might not even be Viagra in the medicine you have purchased! In addition to this, men suffering from ED can reduce the risk of adverse effects from the medicine by ensuring that you take the medicine in accordance with the instructions provided by either a GP or pharmacist or if all else fails, on the patient information leaflet included in the box. This will ensure that you aren’t taking an underdose, in which case the drug may not do its job, or an overdose, whereby unpleasant and potentially dangerous side effects may present.

The final potential safety issue with Viagra that I will be looking at is the potential for it to interact with other drugs. Viagra has been shown to interact with some antibiotics such as Cimetidine and Erythromycin. This is because these drugs are broken down by the same device responsible for the breakdown of Viagra. The two drugs then effectively compete to be broken down. This results in less Viagra being broken down in a given time, which leads to its concentration rising and therefore the effects, both positive and negative, will increase in intensity and duration. Care should be taken when using Viagra and the above medications together and should any side effects present, the Viagra should be stopped immediately. In addition to this, because Viagra causes vasodilation of blood vessels and therefore decreases blood pressure, if this drug is administered alongside a blood pressure lowering medicine then there is the potential for the effects to be additive. This may mean that blood pressure falls too much and the patient becomes hypotensive – leading to dizziness, lightheadedness, fainting, nausea etc. As with any drug, there are many drug interactions possible, care should, therefore, be taken by the prescriber, and the patient in watching out for adverse effects.

In conclusion, as with all drugs there is the potential for safety issues with Viagra, however so long as you as the patient are compliant with the instructions provided, and that care is taken to monitor adverse effects etc, then the safety of Viagra is no less than any of the other hundreds of thousands of medicines on the UK market.

 

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References:

http://www.rxlist.com/viagra-drug/side-effects-interactions.htm

http://en.wikipedia.org/wiki/Allergy

Professor Tracy Robson, QUB, 2014 Lecture on Pharmacogenomic influences on drug metabolism

 

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].

2 thoughts on “Is Viagra/Sildenafil Safe?

  1. can I take Viagra with blood pressure reducing tablets

    1. It will be perfectly safe to take medication to treat erectile dysfunction (ED) if you are taking anti-hypertensives.

      In order to prescribe safely our doctor would need to have a complete record of your medication.

      Best Wishes

      Angela Lillie
      Pharmacist
      Assured Pharmacy
      01625 460 621
      http://www.assuredpharmacy.co.uk

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