Side Effects of Viagra: How Safe is Viagra/Sildenafil?

viagra-pfizer-100mg-4-tablets_2Viagra (sildenafil) is the most common medication taken by men who experience Erectile Dysfunction. This is a condition where the man has difficulty maintaining an erection firm enough for sexual intercourse. Viagra works by increasing the amount of nitric oxide present in the body, a chemical which helps blood vessels in the penis to relax and open. This then allows the development and maintenance of an erection. Viagra does not cause the erection to develop, sexual stimulation is still required.1

Viagra has been proven to be a very effective medication. In clinical trials as compared with placebo, it has been established to significantly improve erectile function.2 However it is not suitable for everyone because of the effects it has upon the body.

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Many men taking Viagra do not experience any side effects. If experienced, the most common side effects that this medication will cause are generally mild and short-lasting. These include a headache and facial flushing, with around 10% of men taking the medication experiencing these.3 Slightly less frequently reported, between 1 -10% of men, are indigestion, a congested nose, dizziness, muscle aches or pains and a blue tint to the vision.2,3 These symptoms can generally be dealt with easily using over-the-counter treatments if necessary. A painkiller such as paracetamol can be taken for a headache, along with drinking more water to stay hydrated. If nasal congestion is a problem, a decongestant such as Sudafed could be tried. If side effects last longer than seem normal, or are thought to be more severe, medical advice should be sought.

Due to the type of medication that Viagra is, it can cause a slight reduction in blood pressure. For most men, this is not a problem. However, it can be an issue in men who are prescribed drugs called nitrates. Nitrates are a type of medication generally used in the treatment and relief of angina. These medications also cause a lowering of blood pressure. Therefore, if both are taken together the effect of lowered blood pressure is exaggerated. Blood pressure may be lowered so much as to have dangerous consequences. These medications should therefore never be taken together.

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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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There have been some more serious side effects reported from men who have taken Viagra. These are much less common. Sudden hearing loss or vision loss have been reported. It has not been confirmed if this was as a direct consequence of taking the Viagra or the result of a pre-existing condition. If either of these symptoms present medical help should be sought straight away. There have also been reports of the erection failing to go away on its own. This is called priapism and can be extremely painful. It can also cause damage to the penis and so any resulting erection lasting more than four hours should be an indication to seek medical help.

All possible side effects of a medication have to be listed in its Patient Information Leaflet (PIL). These are generally extremely numerous and are categorised into how common they have been reported to be. If you are beginning treatment with, or are currently taking, Viagra you should familiarise yourself with this leaflet, which is also available online. If you experience what you think is a side effect of this medication check the leaflet to see if it is listed and talk to a healthcare professional such as your pharmacist or doctor for advice. Even if the symptom is not listed seek advice as it is possible that it is an unlisted side effect.

TViagra & Alcoholhe possibility of experiencing side effects from Viagra can potentially be reduced. Men should not drink alcohol while taking Viagra. Alcohol can increase the time it takes for the drug to work, and also makes getting an erection more difficult in the first place. Viagra is normally recommended to be taken on an empty stomach. However, if side effects are experienced, taking the medication with food may reduce the symptoms. On the flip side, this will reduce the absorption of Viagra and therefore may reduce its effectiveness as well. There are several different doses of Viagra. If side effects are experienced, you should consult your doctor. They may recommend trying a lower dose of the medication to see if this will reduce side effects while still maintaining the effect required.

It is also important to remember that Viagra can interact with a number of other medications. This can increase or decrease the effect of either medication and/or cause unpleasant or dangerous side effects. You should talk to your doctor about the other medications you are on before you start on Viagra. Medications that can interact with Viagra include nitrates, alpha-blockers such as tamsulosin, ketoconazole, clarithromycin and other drugs for erectile dysfunction. Recreational drugs can also cause interactions and side effects, such as “poppers” also known as amyl nitrate and butyl nitrate.

Viagra Side EffectsIf side effects are intolerable, this is not the only option in the pharmacological treatment of erectile dysfunction. Two other oral treatments exist, Levitra and Cialis, and these have different side effect profiles. The effect of Cialis lasts much longer than that of the other two drugs, and so it is important to remember that if side effects are experienced these can last much longer too. If these drugs are also unsuitable because of side effects a further two pharmacological treatments may be trialled. Caverject (alprostadil) is injected directly into the penis, and MUSE (also containing a form of alprostadil) is a pellet inserted into the opening of the urethra. If pharmacological treatment does not prove satisfactory there are mechanical devices available including vacuum pumps to allow the development and maintenance of an adequate erection.2

Viagra is a reliable, effective treatment for erectile dysfunction. It has been proven at doses of 50mg or 100mg to help approximately 4 in 5 men to get and keep erections hard enough for sexual intercourse. In most men side effects will be insignificant and brief, such as a headache and nasal congestion. In rare cases, more serious side effects can occur, and if so these should be immediately reported to a medical professional. By having a consultation with a doctor to see if Viagra is suitable for you, it should decrease the chance of these serious side effects. If side effects prove to be unbearable there are several other options in the treatment of erectile dysfunction with different side effect profiles.

Call us at the pharmacy to have a private conversation with one of our pharmacists if you would like more details on side effects, dosage or interactions with other medicines you are taking.

 

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References

  1. Mayo Foundation for Medical Education and Research http://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/in-depth/erectile-dysfunction/art-20047821 Accessed 03.05.15
  2. British Pregnancy Advisory Society https://www.bpas.org/bpasman/viagra Accessed 03.05.15
  3. com: Viagra Side Effects http://www.drugs.com/sfx/viagra-side-effects.html Accessed 03.05.15
  4. Viagra PIL https://www.medicines.org.uk/emc/PIL.2367.latest.pdf Accessed 03.05.15
  5. Pfizer: Viagra https://www.viagra.com/learning/how-does-viagra-work Accessed 04.05.15

 

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].

One thought on “Side Effects of Viagra: How Safe is Viagra/Sildenafil?

  1. Hello.
    I have been prescribed recently viagra 25mg which helps by making my already erection even harder. Which is good.
    Can viagra harm my body in anyway as side effects and how many can i take per week and can i use more than one per day if i feel like having sex 2 or 3 times per day?

    Thank you.
    Neil

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