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Sildenafil citrate, commonly known by the brand name, is a prescription-only medicine used to treat erectile dysfunction (ED) in adult men. It works by improving blood flow to the penis, helping to achieve and maintain an erection during sexual activity.

Dosage and Administration

Sildenafil is available in 25mg, 50mg, and 100mg strengths.

  • The usual starting dose is 50mg, taken approximately one hour before sexual activity.
  • Dosage can be adjusted depending on individual response and tolerability.
  • Take only one tablet in 24 hours, with or without food.
  • Avoid grapefruit juice, as it can increase the risk of side effects.
  • A high-fat meal may delay onset of action.

Effectiveness

Sildenafil has been shown to be effective in up to 80% of men with ED, with effects typically noticeable within 30 to 60 minutes, and lasting for up to 4–5 hours.

Side Effects

Common side effects include:

  • Headache
  • Flushing
  • Nasal congestion
  • Indigestion

Less common but serious effects include visual disturbances, hearing changes, or prolonged erections. Seek medical attention if severe or persistent side effects occur.

Contraindications

Sildenafil should not be used by those:

  • Taking nitrates for chest pain
  • With severe heart or liver conditions
  • Under 18 years of age
  • With certain medication interactions (e.g. alpha-blockers, antifungals, antibiotics)

Interactions

Inform your doctor of all medications and supplements before use. Interactions may occur with:

  • Nitrates
  • Alpha-blockers
  • Some antibiotics and antifungal medicines

Alcohol and Heart Conditions

Avoid excessive alcohol while taking sildenafil, as it can lower blood pressure and increase side effect risk. Use with caution if you have any heart-related conditions.

Availability and Cost

Sildenafil is available by prescription only in the UK.

  • Generic versions are more affordable than branded Viagra.
  • Supplied by licensed UK pharmacies such as Online Chemist.
  • Avoid counterfeit products from unregulated websites.

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Last updated 14 September 2023

On 14 March 2023, the UK Medicines regulator approved an application to reclassify the erectile dysfunction medication Cialis. When marketed asCialis Together(tadalafil 10mg), it will be a ‘P’ (pharmacy) medication, and so available ‘over the counter’ in pharmacies – see. This follows the 2018, ‘P’ classification of (sildenafil 50mg) which has been available OTC, without a prescription, since then.

This decision is good news for men’s health …. Erectile dysfunction can be a debilitating condition, so it’s important men feel they have fast access to quality and legitimate care

Dr Laura Squire, MHRA’s Chief Officer for Healthcare, Quality and Access

Unfortunately, there is a strong black market in the UK for ED medicines, which are often unlicensed or counterfeit. UK Border Force and the MHRA seize millions of pounds of these fake products from criminals annually. This new classification of tadalafil 10mg will enable men who suffer from ED to obtain it safely from a local pharmacy.

Sanofi, the drug manufacturer, is expected to launch Cialis Together later in 2023. Cialis Together will be available to purchase in pharmacies without a prescription by men over 18 with erectile dysfunction. Cialis Together tablets will contain 10mg tadalafil and the maximum pack size will be 8 tablets. Other doses and pack sizes of Cialis and tadalafil will still be available on prescription through doctors and specially trained pharmacists. Before purchase in a pharmacy there must be an assessment with a pharmacist, who will check that Cialis Together is appropriate and safe, or whether consultation with a GP is necessary.

What does this mean for patients?

Men suffering with ED will have another treatment option with the convenience of purchasing it in their local pharmacy, including pharmacies found inside supermarkets (eg. Tesco, Asda, Sainsbury’s). The pharmacist will ask some health questions, may check blood pressure, and will advise on treatment with Cialis Together or Viagra Connect, or the need to consult a GP. Pharmacies usually have a private room for such discussions.

Cialis Together is a 10mg tadalafil product for use at least 30 minutes prior to anticipated sexual activity. Its effects can last. It is not recommended for daily use. The maximum recommended dose of Cialis Together will be one tablet in 24 hours. Prescription Cialis and tadalafil will still be available at different doses.

Dr Fox welcomes the wider access to ED medication for men that Cialis Together classified as a ‘P’ OTC medication will provide. We at Dr Fox are aware of the difficulties men have in discussing ED with their GPs and in accessing ED medication. We know that Cialis is effective and safe for most men and this change provides another option for obtaining ED treatment. Pharmacists are health professionals who are able to give ED advice but they will also know when to refer men who would benefit from a doctor’s assessment. ‘P’ medicines can also be supplied on prescription, and we will offer Cialis Together, when available, alongside our other competitively priced ED products.

Dr Claire Pugh, Dr Fox Medical Director

Categories of medicine

In the UK have 3 categories:

  • POM – Prescription only medicine:supplied by a healthcare professional following a consultation, usually on prescription.
  • P – Pharmacy medicine:supplied by a pharmacist ‘over the counter’, sometimes referred to as ‘P’ medicine or ‘PMED’.
  • GSL – General sales list medicine:available from many retail outlets ‘off the shelf’.
Every category has a list of medications it can and pregnants

Is it OK to buy medicines online?

Dr Fox is quick to add that while is an acceptable route of delivery for some men, it’s not right for everyone. There are many reasons a man has ED, and his options include:

  • Unlicensed or counterfeit medicine.
  • Strattera (,, ) or, which are not licensed for their intended purpose of treatment but are or are not available on the industry white List.

Viagra has been shown to cause some mild side effects. Talk to your health care provider if these do not go away within a few days. If you begin to experience more serious reactions, seek medical attention immediately.

Common side effects reported from Viagra use include:

  • Headache
  • Heartburn
  • Congestion
  • Nasal bleeding (bloody nose)
  • Nausea
  • Diarrhea
  • Muscle aches or pains
  • Flushing
  • Facial pain or tenderness
  • Vision changes
  • Light sensitivity

More severe side effects include:

  • Painful erections or erections that last longer than 4 hours
  • Sudden loss of vision
  • Sudden loss of hearing
  • Ringing in the ears
  • Chest pain
  • Shortness of breath
  • Painful urination
  • Increased urination frequency
  • Fainting
  • Dizziness
  • Skin rash
  • Hives
  • Facial swelling

If you experience any of these side effects, seek medical attention immediately. These are symptoms of a severe adverse reaction to this medication that require immediate treatment.

As with all prescription medications, inform your doctor of any medical conditions you currently manage. Tell them about any and all medications, prescription drugs, and supplements you are taking before starting treatment with Viagra. Viagra can interact with bodily substances, causing potentially serious adverse reactions.

Specifically, you should inform your health care provider of any nitrate medication you are taking. Remember to mention any herbal products you use, especially St. John’s wort.

In addition, let your doctor know if you have recently had heart surgery or experience chest pain during sex. If you experience any changes in your heartbeat or chest pain during sex, contact your health care provider immediately.

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The atrioventricular (AV) node is the space between the heart and the atrioventricular (AV) node. It allows the heart to beat more easily, which can improve blood flow to the heart. By beating more easily, more effective, and longer-lasting, the AV node helps improve symptoms of heart failure.

Viagra can cause an abnormal beat within the AV node which can cause symptoms such as shortness of breath, flushing, pain, or a pressure sensation on the arm or shoulders. This can be risky and not treatable with medication. Viagra should only be used if signs of heart failure are present. If Viagra is not effective or if symptoms persist, contact your health care provider.

Report any new or worsening symptoms to your doctor.new or worsening symptoms may include fatigue, dizziness, mood swings, lightheadedness, chest pain, a heart attack, or stroke.

If you experience any side effects, contact your health care provider immediately. These are symptoms of a side effect of Viagra.

As with all prescription medications, inform your doctor of any depression, health problems, or adrenal gland problems. If you develop any changes to your mood, especially if you have any, contact your health care provider immediately.

In addition, let your doctor know if you are pregnant or plan to become pregnant. Viagra can cause a dangerous drop in blood pressure, especially when taken with nitrates.

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What is Viagra and How Does it Work?

Viagra is a medication that works by relaxing the blood vessels in the penis, allowing for increased blood flow when sexually aroused. This allows the body to compensate for the loss of blood flow by increasing the length and pressure of theAV node.

Viagra works by enhancing the natural erectile function of the male partner, which can have potential side effects such as delayed erections, increased pressure on the arm, and sudden loss of vision in one or both eyes.

Viagra contains the active ingredient sildenafil. Viagra is used to treat erectile dysfunction (ED) in men.

INTRODUCTION ABOUT VIAGRA 50MG TABLET

VIAGRA 50MG TABLET is used for erectile dysfunction in adult men. It contains a medicine called which is a phosphodiesterase-5 (PDE5) inhibitor. It works by relaxing the blood vessels in your penis, allowing blood to flow into your penis when you get sexually excited and causing an erection. This medicine will only help you to get an erection if you are sexually excited (stimulated).

Individuals must take VIAGRA 50MG TABLET only under careful medical supervision. It is prescribed to take one dose per day with or without meals, 30 to 60 mins before getting sexually stimulated. Avoid taking heavy meals just before or after taking the medicine as it may reduce the effectiveness of this medicine.

Do not consume alcohol or take medicines for chest pain, HIV infection or pulmonary arterial hypertension while taking VIAGRA 50MG TABLET as they could lead to potential drug-drug interactions.

Before taking VIAGRA 50MG TABLET, inform your doctor if you have any liver, kidney, or heart problems. You must also inform your doctor if you have pulmonary arterial hypertension (PAH) and are taking medications for the same, have penile deformities, stomach ulcers or blood cancer as a precaution.

The most common side effects of taking VIAGRA 50MG TABLET are flushing, headache, dizziness, blurred vision, and muscle pain. Consult your doctor if any of the side effects trouble you.

As with all prescription medicines, including other medicines, VIAGRA 50MG TABLET may cause various side effects.

NEW YORK (Reuters) - Pfizer Inc will offer consumers, including men, the ability to buy more erectile dysfunction drugs, its U. S. Food and Drug Administration task force said in a study on Tuesday.

The market for erectile dysfunction drugs, which include Viagra, Levitra and Cialis, is growing at a rapid rate and is expected to reach $1.4 trillion by 2015, the agency said in a report.

The report, which also will be a joint news conference on drug safety and market performance, also examined the effectiveness of such drugs, including the drugs that are sold under brand names such as Cialis, Adderall and Spedra, the agency said.

"In some cases, erectile dysfunction drugs can be a source of shame and frustration for many men," said Dr. Irwin Goldstein, chairman of the U. medical directorate and the chief of the Department of Urology at the Johns Hopkins University School of Medicine. "But many men can find relief through a treatment that works."

The FDA, which has not approved a single drug for erectile dysfunction, is working on new drugs that could do so for patients who may be on a low dose of one or more drugs, according to the report.

A generic version of Viagra, a rival drug, had U. sales of $1.4 billion last year, up 11 percent from $1.58 billion a year earlier.

The report was published in the February 2019 issue of the Journal of the American Medical Association.

The U. report also examined a similar product, marketed as, which is sold under the brand name Revatio. It also will be sold by a rival drug company, which makes, which was FDA-approved last year as Cialis.