In July 2005, the US Food and Drug Administration (FDA) updated labeling for tadalafil (Cialis), vardenafil (Levitra), and sildenafil (Viagra) to reflect a small number of post-marketing reports of sudden vision loss, while acknowledging that "...it is not possible to determine whether these oral medicines for erectile dysfunction were the cause of the loss of eyesight or whether the problem is related to other factors such as high blood pressure or diabetes, or to a combination of these problems. "[25] A careful review of pooled data from clinical trials containing well documented information about the dose and duration of exposure to the drug for a large number of patients, yields no evidence for an increased risk of non-arteritic anterior ischemic optic neuropathy or other adverse ocular events associated with PDE5 inhibitor use.
Rare but serious adverse effects found through postmarketing surveillance include prolonged erections, severe low blood pressure, myocardial infarction (heart sildenafil citrate tablet attack), ventricular arrhythmias, stroke, increased intraocular pressure, and sudden hearing loss.
[4] In October 2007, the FDA announced that the labeling for all PDE5 inhibitors, including sildenafil, required a more prominent warning of the potential risk of sudden hearing loss. Care should be exercised by people who are also taking protease inhibitors for the treatment of HIV infection.
Protease inhibitors inhibit the metabolism of sildenafil, effectively multiplying the plasma levels of sildenafil, increasing the incidence and severity of side effects. Those using protease inhibitors are recommended to limit their use of sildenafil to no more than one 25 mg dose every 48 hours.
| Brand | Price per Tablet (€) | Pack Size | Manufacturer |
|---|---|---|---|
| Viagra | 15 | 30 | Pfizer |
| Sildenafil UK | 10 | 20 | Generic Labs |
| Kamagra | 8 | 10 | Ajanta Pharma |
| Revatio | 18 | 30 | Pfizer |
[4] Other drugs that interfere with the metabolism of sildenafil include erythromycin and cimetidine, both of which can also lead to prolonged plasma half-life levels.
[8] It also results in dilation of the blood vessels in the lungs. Pfizer originally discovered the medication in 1989 while looking for a treatment for angina. [11] It was approved for medical use in the United States and in the European Union in 1998. [5][8][11][12] In 2023, it was the 151st most commonly prescribed medication in the United States, with more than 3 million prescriptions. [13][14] It is available as a generic medication.
[15][16] In the United Kingdom, it is available as a pharmacy medicine. The primary indication of sildenafil is treatment of erectile dysfunction (inability to sustain a satisfactory erection to complete sexual intercourse). Its use is now one of the standard treatments for erectile dysfunction, including for males with diabetes mellitus. Tentative evidence suggests that sildenafil may help males who experience antidepressant-induced erectile dysfunction. While sildenafil improves some markers of disease in people with pulmonary arterial hypertension, it does not appear to affect the risk of death or serious side effects.
Sildenafil and other PDE5 inhibitors are used off-label to alleviate vasospasm and treat severe ischemia and ulcers in fingers and toes for people with secondary Raynaud's phenomenon;[9][21] these drugs have moderate efficacy for reducing the frequency and duration of vasospastic episodes. [9] As of 2016,[update] their role more sildenafil 10mg generally in Raynaud's was not clear. Sildenafil has shown some potential for improving exercise performance at high altitudes. However, its overall efficacy is not clear. Sildenafil has been studied for high-altitude pulmonary edema (HAPE), but its use is currently not recommended for that indication. The use of sildenafil and an α1 blocker (typically prescribed for hypertension or for urologic conditions, such as benign prostatic hypertrophy) at the same time may lead to low blood pressure, but this effect does not occur if they are taken at least 4 hours apart.
| Cost Component | Percentage of Price (%) | Explanation |
|---|---|---|
| Manufacturing | 40% | Production and quality control |
| Distribution | 20% | Transportation and logistics |
| Retail Markup | 25% | Pharmacy profit margin |
| Taxes & Fees | 15% | VAT, import duties |
Concomitant use of nitric oxide donors, organic nitrites and nitrates,[30] such as: nitroglycerinisosorbide mononitrateisosorbide dinitratesodium nitroprussidealkyl nitrites (commonly known as "poppers") Concomitant use of soluble guanylyl cyclase stimulators, such as riociguat Sildenafil should not be used if sexual activity is inadvisable due to underlying cardiovascular risk factors.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Kamagra Polo | 100mg | 180 + 8 Pills | 446.52€ 425.26€ | |
| Viagra Generic | 200mg | 270 + 10 Pills | 379.76€ 361.68€ | |
| Viagra Generic | 50mg | 60 + 4 Pills | 83.93€ 79.93€ | |
| Kamagra Oral Jelly | 100mg | 30 + 5 Sachets | 136.20€ 129.71€ | |
| Viagra Generic | 100mg | 60 + 4 Pills | 96.36€ 91.77€ | |
| Kamagra Soft Tabs | 100mg | 12 Pills | 57.55€ 54.81€ | |
| Viagra Generic | 200mg | 20 Pills | 61.69€ 58.75€ | |
| Viagra Generic | 200mg | 120 + 8 Pills | 204.80€ 195.05€ | |
| Viagra Generic | 100mg | 30 + 4 Pills | 60.91€ 58.01€ | |
| Kamagra Oral Jelly | 100mg | 110 + 9 Sachets | 334.87€ 318.92€ | |
| Viagra Generic | 150mg | 180 + 10 Pills | 236.46€ 225.20€ | |
| Viagra Generic | 25mg | 120 + 6 Pills | 125.56€ 119.58€ | |
| Viagra Generic | 50mg | 270 + 8 Pills | 198.48€ 189.03€ |
Sildenafil's popularity with young adults has increased over the years.
Some of these side effects can be found in the table below, and for a full list of side effects, please read the Patient Information Leaflet found in each box.2 Find the clinically proven ED treatment that suits you best. Specialists in medicine, nutrition, performance, and diagnostics. BSc (Hons) MBBS MRCGP AFHEA MA (Hons) AFMCP Viagra Connect 50 mg film-coated tablets. Viagra Connect 50 mg film-coated tablets. Sildenafil, sold under the brand name Viagra among others, is a medication used to treat erectile dysfunction and pulmonary arterial hypertension.
[4][8] It is also sometimes used off-label for the treatment of certain symptoms in secondary Raynaud's phenomenon. [9] It is unclear if it is effective for treating sexual dysfunction in females. [8] It can be taken orally (swallowed by mouth), intravenously (injection into a vein), or through the sublingual route (dissolved under the tongue). [8][10] Onset when taken orally is typically canadian sildenafil citrate within twenty minutes and lasts for about two hours. Common side effects include headaches, heartburn, and flushed skin.
[8] Caution is advised in those with cardiovascular disease. [8] Rare but serious side effects include vision problems, hearing loss, and prolonged erection (priapism) that can lead to damage to the penis. [8] Sildenafil should not be taken by people on nitric oxide donors such as nitroglycerin, as this may result in a serious drop in blood pressure. Sildenafil acts by blocking phosphodiesterase 5 (PDE5), an enzyme that promotes breakdown of cGMP, which regulates blood flow in the penis. [8] It requires sexual arousal to work, and does not by itself cause or increase sexual arousal. [32] Sildenafil's brand name, Viagra, is widely recognized in popular culture, and the drug's association with treating erectile dysfunction has led to its recreational use. [33] The reasons behind such use include the belief that the drug increases libido, improves sexual performance,[33] or permanently increases penis size. [34] Studies on the effects of sildenafil when used recreationally are limited, but suggest it has little effect when used by those who do not have erectile dysfunction. In one study, a 25 mg dose was shown to cause no significant change in erectile quality, but did reduce the postejaculatory refractory time.
| Dosage (mg) | Average Price per Tablet (€) | Common Brands |
|---|---|---|
| 25 | 8 | Generic, Kamagra |
| 50 | 12 | Pfizer, Bluepill |
| 100 | 15 | Viagra, Revatio |
[35] This study also noted a significant placebo effect in the control group.
Viagra Connect was the first erectile dysfunction (ED) treatment available in the UK without a prescription. It contains sildenafil, the same active ingredient found in prescription Viagra, which is a medicine that’s been trusted by millions of men worldwide since it first came to market in the late 1990s. Launched as an over-the-counter option in 2018, Viagra Connect was developed to make ED treatment more accessible and discreet. Instead of needing a GP appointment, it can now be purchased directly following a short consultation or assessment with a pharmacist. Viagra Connect, which contains sildenafil, typically takes around 30-60 minutes to start working and lasts for up to 4 hours.1 When you get aroused, your body produces a molecule called cGMP which helps to stimulate an erection by increasing blood flow to the penis.1 However, for people experiencing erectile difficulties, an enzyme known as PDE5 normally breaks cGMP down, restricting blood flow and causing the erection to subside.1 Viagra Connect blocks the action of PDE5, allowing more blood to flow to the penis.
The resulting erection is firmer and usually lasts long enough to allow for satisfying sex.1 The difference between Viagra and Viagra Connect is that Viagra is only available via a prescription, whereas Viagra Connect can be bought over the counter without a prescription. We’re a holistic health platform built to help you take control, with treatment, guidance, and ongoing support that actually works. When you choose Viagra Connect with Numan, you’re not just getting medication, but complete care designed to help you perform your best. Complete a Numan Erectile Dysfunction Blood Test to uncover underlying causes such as low testosterone or cardiovascular risk factors, so you can get more effective treatment. Get access to our doctors and clinicians should you require any medical help with your treatment.
If hormone issues related to erectile dysfunction are suspected, Numan offers access to a dedicated team who provide personalised treatment, monitoring, and support. All treatments are shipped quickly for free, in discreet packaging directly to your desired address. And if plans change, so can your delivery, all online. With thousands of successful patients behind us, our approach is tried, tested, and trusted. Viagra Connect has the same side effect profile as both Viagra and generic sildenafil. Unprescribed recreational use of sildenafil and other PDE5 inhibitors is noted as particularly high among users of illegal drugs. [36] Sildenafil is sometimes used to counteract the effects of other substances, often illicit.
In clinical trials, the most common adverse effects of sildenafil use included headache, flushing, indigestion, nasal congestion, and impaired vision, including photophobia and blurred vision. [4] Some sildenafil users have complained of seeing everything tinted blue (cyanopsia). [24] This cyanopsia can be explained because sildenafil, while selective for PDE5, does have some affinity for PDE6, which is the phosphodiesterase found in the retina. Patients thus taking the drug may experience colorvision abnormalities. Some complained of blurriness and loss of peripheral vision. [33] Some users mix it with methylenedioxymethamphetamine (MDMA, ecstasy), other stimulants, or opiates in an attempt to compensate for the common side effect of erectile dysfunction, a combination known as "sextasy", "rockin' and rollin'", "hammerheading", or "trail mix".