Will Sildenafil or Viagra Make My Penis Bigger?

Short facts about Viagra

Viagra is the brand name containing the active compound Sildenafil, the first drug used for erectile dysfunction treatment.
Since its launch as a prescription in 1998, 40 million men around the globe have used Viagra at least once.
The researchers of Viagra wanted to discover a medicine for the cure of cardiovascular diseases, instead, they developed a medicine which could reverse impotence or erectile dysfunction for the first time.
Viagra is the most counterfeited drug in the world.

  • How was the blue pill discovered?

Sildenafil (compound UK-92,480) was synthesized by a group of pharmaceutical chemists working at Pfizer’s Sandwich, Kent, Research facility in England. It was initially studied for use in hypertension (high blood pressure) and angina pectoris (chest pain, a symptom of ischemic heart disease). Phase I clinical trials suggested the drug had little effect on angina, but it could induce marked penile erections. Therefore, Pfizer decided to market it for erectile dysfunction, rather than for angina. The drug was patented in 1996, approved for use in erectile dysfunction by the FDA on 27 March 1998, becoming the first oral treatment approved to treat erectile dysfunction in the United States, and consequently, in several counties in Europe.

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  • What is erectile dysfunction?

Erectile dysfunction (ED), also known as impotence represents the inability to attain or maintain an erection of the penis adequate for the sexual satisfaction of both partners. Erectile dysfunction has a significant impact on the physical and psychological health of men worldwide and can also affect the quality of life of both the sufferers and their partners. 3.4

  • How does erection work?

Penile erection is a complex phenomenon which involves a delicate and coordinated balance between neurological, vascular and tissue compartments. This includes arterial dilation, relaxation of the trabecular smooth muscle, and activation of the corporeal veno-occlusive mechanism. 3.4
The erection is the result of increased and “trapped” blood flow into the penis. Usually stimulated by either sexual thoughts or direct contact with the penis, the central nervous system commands to the muscular system to relax.
When muscles in the penis are relaxed, they allow for increased blood flow through the penile arteries. This blood fills two chambers inside the penis called the corpora cavernosa. As the chambers fill with blood, the penis grows rigid. Erection ends when the muscles contract and the accumulated blood can flow out through the penile veins. 3.4

  • Which are the causes of erectile dysfunction?

Both health and emotional problems can lead to the occurrence of erectile dysfunction. The erection problems can result from lower blood flow or harm to the nerves in the penis.
The risk of getting erectile dysfunction can be increased by the following factors:

  1. Increased age;Manage Your Risk Words Dice Reduce Costs Liabilities
  2. High blood sugar (diabetes);
  3. High blood pressure;
  4. High cholesterol;
  5. Damage from cancer or surgery;
  6. Smoking;
  7. Alcohol use;
  8. Cardiovascular disease;
  9. Drug or alcohol abuse
  10. Obesity or being overweight;
  11. Lack of exercise.

Erectile dysfunction may occur because:

  1. Not enough blood flows into the penis;
  2. The penis cannot store blood during an erection;
  3. Nerve signals from the brain or spinal cord do not reach the penis.

Because sex activity needs the mid and body to work together, erectile dysfunction can be caused by emotional or relationship problems which include:

  1. Depression;
  2. Relationship conflicts;
  3. Stress at home or work;
  4. Worry about sexual performance.
  • How can you prevent erectile dysfunction?
  1. Be more careful with nutrition.
    Foods that can cause heart attacks due to restricted blood flow in the coronary arteries can also impede blood flow to and within the penis. Diets that include very few fruits and vegetables along with lots of fatty, fried, and processed foods can contribute to decreased blood circulation throughout the body. Also, studies have shown that ED is relatively uncommon among men who eat a traditional Mediterranean diet, which includes fruits, vegetables, whole grains, heart-healthy fats including nuts and olive oil, fish, and wine, particularly red.
  2. Maintain a healthy weight.
    Men who are overweight can bring many health problems such as type 2 diabetes. Type 2 diabetes can cause nerve damage throughout the body including the nerves that supply the penis.
    Avoid high blood pressure and high cholesterol.
  3. High cholesterol or high blood pressure can damage blood vessels, including those that bring blood to the penis.
  4. Drink alcohol in moderation.
    Chronic consumption of alcohol can cause liver damage, nerve damage, and other conditions which can interfere with the normal balance of male sex hormone levels, so that can lead to the occurrence of erectile dysfunction.
  5. Exercise regularly.
    A sedentary lifestyle causes erectile dysfunction. Running, swimming, and other forms of aerobic exercise have been shown to help prevent erectile dysfunction.
  6. Do not rely on Kegels.
    Kegel exercise, also known as pelvic floor exercise, consists of repeatedly contracting and relaxing the muscles that form part of the pelvic floor, now sometimes colloquially referred to as the “Kegel muscles”. Kegels can be helpful for men and women suffering from incontinence, but there’s no evidence that they prevent erectile dysfunction.
  7. Keep track of testosterone.
    Even in healthy men, testosterone levels often begin falling sharply around age 50. Every year after age 40, a man’s testosterone level typically falls about 1.3%.
  8. Avoid anabolic steroids.
    The administration of anabolic steroids, drugs which are often abused by athletes and bodybuilders, should be avoided. These drugs can contract the testicles and block their ability to make testosterone.
  9. Stop smoking.
    Smoking cigarettes can harm blood vessels and curb blood flow to the penis. The nicotine makes blood vessels contract, which can hamper blood flow to the penis.
  10. Avoid stress.
    Psychological stress boosts levels of the hormone adrenaline, which makes blood vessels contract.

 

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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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Absorption

After oral administration, Viagra (sildenafil) is rapidly absorbed. Maximum observed plasma concentrations are reached within 30 to 120 minutes (median 60 minutes) of oral dosing in the fasted state. The mean absolute oral bioavailability is 41% (range 25-63%). When is taken with food, the rate of absorption of Viagra is reduced.

Distribution

The mean steady-state volume of distribution (Vd) for sildenafil is 105 l, indicating distribution into the tissues. After a single oral dose of 100 mg, the mean maximum total plasma concentration of sildenafil is approximately 440 ng/mL (CV 40%). Since sildenafil (and its major circulating N-desmethyl metabolite) is 96% bound to plasma proteins, this results in the mean maximum free plasma concentration for sildenafil of 18 ng/mL (38 nM). Protein binding is independent of total drug concentrations.

Biotransformation

Sildenafil is cleared predominantly by the CYP3A4 (major route) and CYP2C9 (minor route) hepatic microsomal isoenzymes. The major circulating metabolite results from N-demethylation of sildenafil.
This metabolite has a phosphodiesterase selectivity profile similar to sildenafil and an in vitro potency for PDE5 approximately 50% that of the parent drug. Plasma concentrations of this metabolite are approximately 40% of those seen for sildenafil. The N-desmethyl metabolite is further metabolised, with a terminal half-life of approximately 4 h.

Elimination

The total body clearance of sildenafil is 41 L/h with a resultant terminal phase half-life of 3-5 h. After either oral or intravenous administration, sildenafil is excreted as metabolites predominantly in the faeces (approximately 80% of administered oral dose) and to a lesser extent in the urine.

 

3D rendering Many containers Viagra in a pile

  • How does Viagra work? Mechanism of action

Like the other phosphodiesterase type 5 inhibitors, Viagra works only when you are sexually stimulated, but may make you last longer in bed.
Sildenafil is an oral therapy for erectile dysfunction. In the natural setting, i.e. with sexual stimulation, it restores impaired erectile function by increasing blood flow to the penis. The physiological mechanism responsible for erection of the penis involves the release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. Nitric oxide then activates the enzyme called 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. Sildenafil is a potent and selective inhibitor of cGMP specific phosphodiesterase type 5 in the corpus cavernosum, where phosphodiesterase type 5 is responsible for degradation of cGMP. Sildenafil has a peripheral site of action on erections. Sildenafil has no direct relaxant effect on isolated human corpus cavernosum but potently enhances the relaxant effect of NO on this tissue. When the NO/cGMP pathway is activated, as occurs with sexual stimulation, inhibition of PDE5 by sildenafil results in increased corpus cavernosum levels of cGMP. Therefore, sexual stimulation is required for sildenafil to produce its intended beneficial pharmacological effects.

  • Is Viagra influenced by the co-administration of other drugs?

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
Viagra may affect the way other medicines work, and other medicines may affect the way Viagra works, causing side effects. Especially tell your healthcare provider if you take any of the following:
Nitrates: nitroglycerine, isosorbide dinitrate, isosorbide mononitrate, nitroprusside, amyl nitrite,), medicines used to treat angina pectoris, because it increases the hypotensive effect of the nitrates. Using Viagra with this type of drugs may cause an excessive decrease in blood pressure and finally, cardiovascular collapse.
Guanylate cyclase stimulators such as riociguat;
Alpha androgenic blocking agents like doxazosin, tamsulosin, prazosin, silodosin and alfuzosin. Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of VIAGRA with alpha-blockers can lead to a drop in blood pressure or to fainting.
HIV protease inhibitors, such as ritonavir, indinavir sulfate, saquinavir or atazanavir sulfate;
Some types of oral antifungal medicines, such as ketoconazole and itraconazole;
Some types of antibiotics, such as clarithromycin, telithromycin or erythromycin;
Other medicines that treat high blood pressure;
Other medicines or treatments for erectile dysfunction.

  • Is Viagra safe?

In hundreds of clinical trials performed, Viagra proved it is a safe drug. However, Viagra’s side effects include the following:

  1. headache;
  2. flushing;
  3. upset stomach;
  4. abnormal vision, such as changes in color vision
    (such as having a blue colour tinge) and blurred vision;
  5. stuffy or runny nose;
  6. back pain;
  7. muscle pain;
  8. nausea;
  9. dizziness;
  10. rash.

Viagra can cause also serious side effects. Rarely reported side effects include:

  1. An erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, get medical help right away. If it is not treated right away, priapism can permanently damage your penis.
  2. Sudden loss of vision in one or both eyes;
  3. Non-arteritic anterior ischemic optic neuropathy (NAION);
  4. Sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness.
  5. Stop using the drug and call immediately your healthcare professional if you experience any of these side effects.
  • Is Viagra suitable for me?

Before you take Viagra, tell your healthcare provider if you:

  1. have or have had heart problems such as a heart attack, irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure;
  2. have had heart surgery within the last 6 months;
  3. have pulmonary hypertension;
  4. have had a stroke;
  5. have low blood pressure, or high blood pressure that is not controlled;
  6. have a deformed penis shape;
  7. have had an erection that lasted for more than 4 hours;
  8. have problems with your blood cells such as sickle cell anaemia, multiple myeloma, or leukaemia;
  9. have retinitis pigmentosa, a rare genetic eye disease;
  10. have ever had severe vision loss, including an eye problem called NAION;
  11. have bleeding problems;
  12. have or have had stomach ulcers;
  13. have liver problems;
  14. have kidney problems or are having kidney dialysis;
  15. have any other medical conditions.

Young man might have impotence problems?

  • How should I take Viagra?

Viagra tablets come in three standard doses of 25 mg, 50 mg and 100 mg. The tablets of Viagra are blue, rounded diamond-shaped tablets, marked “PFIZER” on one side and “VGR 25”, “VGR 50” or “VGR 100” on the other side.
The dose you should use to treat your condition depends on your general health and how well the drug works for you.

  • Who should take 50 mg tablets?

50 mg is the most common dosage for Viagra. Your doctor may recommend it if you are taking Viagra for the first time. Most men find that this dosage is sufficient to treat their erectile dysfunction and improve their sexual experience. It is recommended to take Viagra approximately one hour before sexual activity.

  • Who should take 100 mg tablets?

100 mg is the highest recommended dosage of Viagra. It is not recommended to take more than 100 mg per day. Viagra 100 mg tablets are suitable for men who find that they do not get an erection hard enough for penetration when taking the 50 mg tablet. You should try the 50 mg dose first and only increase your intake to 100mg if you find the effect insufficient.

  • Who should take 25 mg tablets?

Viagra 25 mg tablets contain the lowest available dosage. You may be prescribed the 25 mg tablets if you are taking certain types of medication, for example, drugs to control HIV or alpha-blockers for the treatment of high blood pressure.

  • Does the Viagra dosage depend on my age?

No, age -depending dosage adjustments are not required.

  • Is it recommended to increase the dosage if the drug does not work?

If you consider that the dosage you are on is too weak, ask your prescribing doctor whether you can increase it. If you do not have any medical conditions and you are not taking any other drugs, you can increase your dosage from 50 mg to 100 mg. However, you should ask your doctor first.

  • How to find out if Viagra is fake?

Check for colour variations: A real Viagra pill will have the exact blue colour on both sides of the pill. If the colour is very light or has a different shade of colour over the sides, it seems that it is a counterfeit Viagra.
Compare the shape of the pill: the real Viagra pills have a distinct edge and are soft, smooth and uniform. The fake Viagra pills have an indent before the edge and are much jagged.
Check for Viagra logo on the pill: the Viagra logo on the real Viagra pills appear to be dark and the “f”.
No more Viagra pills in the pack: the real Viagra pack has four Viagra pills in them. If any of the Viagra pack consists of more than four pills, then you can easily make out that it is a counterfeit one.
Check the expiration date.

The best way to ensure you purchase legitimate Viagra is to buy it from a reputable seller – Discussed here also.asian female giving pack of blue pills

 

In summary…

Viagra is probably the World’s Most Popular Male Sexual Performance Drug.
Also, it is one of the most counterfeited drugs in the world.
Viagra is an innovative drug, marketed for almost twenty years (since 1998).
Viagra is associated with rapid onset of action – within 14 minutes for some men – and an extended duration of action for up to 12 hours.

  • Will sildenafil or viagra make my penis bigger?

Viagra will not make your penis larger or bigger nor decrease premature ejaculation. It will, however, decrease your refractory time, the time required to achieve a subsequent erection after ejaculation. And it will allow a firmer erection with less stimulation and will make possible a few more erection during the interval of 4-5 hours postdose.

 

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References:

1. https://www.accessrx.com/blog/erectile-dysfunction/7-cool-facts-about-viagra/#
2. https://www.drugs.com/slideshow/viagra-little-blue-pill-1043#
3. K. Hatzimouratidis (Chair), F. Giuliano, I. Moncada, A. Muneer, A. Salonia (Vice-chair), P. Verze EAU Guidelines on Erectile Dysfunction, Premature Ejaculation, Penile Curvature and Priapism
4. Bella A, Lee J, Carrier S, Bénard F, Brock G. 2015 CUA Practice guidelines for erectile dysfunction. Canadian Urological Association Journal. 2015;9(1-2)
5. https://www.urologyhealth.org/urologic-conditions/erectile-dysfunction/causes
6. https://www.webmd.com/erectile-dysfunction/features/protect-your-erection-11-tips#1
7. http://www.ema.europa.eu/Viagra- Summary of product characteristics
8. https://www.viagra.com/questions
9. http://www.supergenericviagra.com/know-the-difference-between-counterfeit-and-real-viagra/

 

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]