Sildenafil

Sildenafil is a medicine that contains the active ingredient sildenafil citrate, which is identical to the ingredient in the branded medicine Viagra. It belongs to a class of drugs called PDE5 inhibitors, which work by relaxing the blood vessels in your penis. When you become sexually aroused, this allows more blood to flow into the penis, helping you get and keep an erection that is firm enough for satisfactory sexual activity. A very important point: sildenafil only works if you are sexually stimulated. It is not an aphrodisiac, it will not increase your sexual desire, and it will not produce an erection on its own. Without sexual arousal, the medicine will not work. Erectile dysfunction (ED) affects at least one in ten men at some point in their lives. It can be caused by physical factors such as diabetes, high blood pressure, high cholesterol, heart disease, or by psychological factors such as stress or anxiety. Before starting any treatment, it is always wise to speak to a doctor or pharmacist to understand the underlying cause of your symptoms.

Sildenafil tablets are available in three different strengths: 25mg, 50mg and 100mg. 50mg tablets – This is the standard starting dose for most men. It is the dose that doctors usually recommend first because it works well for the majority of people while keeping side effects manageable. 25mg tablets – This is a lower dose, used for men who may need to start with a milder option. It is often prescribed for men aged 65 and over, those with liver or kidney problems, or those who experience side effects from the 50mg dose. 100mg tablets – This is the maximum strength. It is used for men who have tried 50mg and found that it does not work well enough, but who tolerate the medicine without troublesome side effects. How do you know if your dose is right? If 50mg works well for you, stick with it. If 50mg works but not quite well enough, and you have no troubling side effects, your doctor may suggest increasing to 100mg. If 50mg gives you side effects such as bad headaches or flushing, your doctor may suggest reducing to 25mg. If 50mg does not work at all after several attempts, speak to your doctor. You may need a different ED treatment such as tadalafil or vardenafil. You should never change your dose on your own. Always speak to a doctor or pharmacist first.

To get the best results from sildenafil, you need to use the medicine correctly. When to take it – Take one tablet approximately 60 minutes before you plan to have sex. However, you can take it anywhere from 30 minutes to 4 hours beforehand. How to take it – Swallow the tablet whole with a glass of water. Do not crush or chew the tablet. With or without food – You can take sildenafil with or without food, but a heavy or fatty meal can delay the medicine from being absorbed. For the best results, take it on an empty stomach or after a light meal. How often can you take it? – You should take no more than one tablet in any 24-hour period. The maximum recommended dosing frequency is once per day. Taking more than one will not make it work better, but it will increase your risk of side effects. Sexual stimulation is essential – Sildenafil only works when you are sexually aroused. You and your partner will still need to engage in foreplay. The medicine simply helps your body respond more easily when you are turned on.

The sildenafil price varies depending on the strength, the pack size, and whether you choose generic sildenafil (which is the same as Viagra but without the brand name). Generic sildenafil is significantly cheaper because it does not carry the branding costs. Price guidance for generic sildenafil: Sildenafil 50mg tablets – 8 tablets typically cost around £13.79, or about £1.72 per tablet. Sildenafil 100mg tablets – 8 tablets typically cost around £14.89, or about £1.86 per tablet. Sildenafil 25mg tablets – 8 tablets typically cost around £9.49. Branded Viagra Connect (50mg) is available from pharmacies with prices starting from approximately £9.99 for 2 tablets. Larger packs work out cheaper per tablet. How to buy sildenafil online – You can legally buy sildenafil online from registered UK online pharmacies such as Access Doctor. The process is straightforward: complete a brief online consultation; a UK-registered doctor or pharmacist reviews your answers; if approved, the pharmacy issues a prescription and dispatches your medication. All regulated online pharmacies are registered with the General Pharmaceutical Council (GPhC). You should never buy sildenafil from unregulated websites or from friends – counterfeit medicines can contain dangerous substances. Can I get sildenafil without a prescription? – In the UK, men over 18 can legally purchase sildenafil 50mg over the counter from a pharmacy after a consultation. This is sold under the brand name Viagra Connect. For other strengths (25mg and 100mg), a prescription is still required.

If you order sildenafil online through a regulated service like Access Doctor, and you complete the consultation before the daily cut-off time (usually mid-afternoon), your order will be dispatched the same day. Most UK online pharmacies offer sildenafil next day delivery as a standard service, with orders arriving by Royal Mail Tracked 24 or a similar courier service. The packaging is discreet – plain and unmarked – so no one else knows what is inside. Once your order is dispatched, you will receive tracking information so you can follow your delivery all the way to your door. Many pharmacies offer free delivery on orders over a certain amount, and some also provide click-and-collect options allowing you to pick up your order from a local pharmacy in as little as 2 hours after approval.

Most men tolerate sildenafil well, but like all medicines, side effects can occur. Most side effects are mild to moderate and short-lasting. Common side effects (may affect up to 1 in 10 men): Headache – reported in about 12% of users Flushing – redness and warmth of your face and neck, reported in about 10% of users Indigestion – affects about 7% of users Altered vision – usually a blue tinge to your vision, with dizziness, can occur in about 3% of users. If dizziness occurs, it is advisable not to drive or operate machinery Nasal congestion – a stuffy or runny nose Back pain or muscle aches – some men experience aching in their muscles, particularly with the 100mg strength Serious side effects – rare but you need to know about them: Priapism – a painful erection that will not go away. If you have an erection that lasts more than 4 hours, you must seek emergency medical attention immediately. If left untreated, priapism can cause permanent damage to your penis and lead to long-term erectile dysfunction. Sudden vision loss in one or both eyes – this can be a sign of a rare but serious condition. If this happens, stop taking sildenafil and seek medical help urgently. Sudden hearing loss – some men have reported a sudden decrease or loss of hearing, sometimes accompanied by ringing in the ears (tinnitus) or dizziness. Chest pains – this occurs uncommonly (affects up to 1 in 100 men). If chest pains occur, seek medical attention immediately. When to seek medical help: If you develop an erection lasting more than 4 hours If you lose your vision suddenly If you develop chest pain, severe dizziness or nausea during sexual activity – stop sexual activity immediately and seek medical attention If you develop sudden hearing loss or ringing in your ears

There are several groups of men who must not take sildenafil. This is very important. Do NOT take sildenafil if: You take any medicine called a nitrate. Nitrates are prescribed for chest pain (angina). Common nitrate medicines include glyceryl trinitrate (GTN), isosorbide mononitrate, isosorbide dinitrate, and amyl nitrite ("poppers"). Taking sildenafil with a nitrate can cause your blood pressure to drop suddenly and dangerously, leading to fainting, heart attack, or even death. You take a medicine called riociguat (Adempas). This is used to treat high blood pressure in the lungs. You have been advised by a doctor to avoid sexual activity because of a heart problem – such as unstable angina, severe heart failure, or a recent heart attack or stroke. You have low blood pressure (hypotension) or high blood pressure not controlled by medicines. You have a rare inherited eye disease – such as retinitis pigmentosa. You have a physical deformity of the penis – such as Peyronie's disease. This condition increases the risk of priapism. You have a blood disorder – such as sickle cell anaemia, multiple myeloma or leukaemia. These also increase the risk of priapism. You have a stomach ulcer or a bleeding problem such as haemophilia. You are allergic to sildenafil or any of the other ingredients in the tablet.

Yes, it is very important to be aware of potential interactions. Dangerous interactions (do not take sildenafil at all): Nitrates – as described above. This is absolute. Poppers (amyl nitrite) – also absolute. Riociguat (Adempas) – also absolute. Interactions that need caution (tell your doctor before starting sildenafil): Alpha-blockers – medicines such as doxazosin, tamsulosin, terazosin, alfuzosin, and silodosin. These are often prescribed for high blood pressure or for prostate problems. If you take an alpha-blocker, your doctor will start you on the lowest dose (25mg). Ritonavir – an HIV medicine that can increase sildenafil levels. If you take ritonavir, the recommended maximum dose is 25mg within a 48-hour period. CYP3A4 inhibitors – certain antifungals (itraconazole, ketoconazole), certain antibiotics (erythromycin, clarithromycin) and some HIV medicines. Your doctor may advise a lower starting dose. What about alcohol? Sildenafil can work with moderate alcohol consumption, but heavy drinking increases the risk of side effects and may reduce the medication's effectiveness. Both sildenafil and alcohol lower blood pressure, which can lead to dizziness or lightheadedness when combined. Moderate drinking (one or two units) is generally fine, but excessive alcohol can independently impair your ability to get an erection and may make you feel more dizzy. What about grapefruit juice? You should avoid grapefruit juice while taking sildenafil, as it can affect the way the medicine works and may increase the level of sildenafil in your blood.

You need to be careful. You should discuss sildenafil with your doctor or pharmacist if you have any of the following: Heart problems – such as a recent heart attack (within the last 6 months), unstable angina, or severe heart failure. High blood pressure that is not well controlled or low blood pressure. A stroke within the last 6 months. Liver problems – if you have liver impairment (such as cirrhosis), a 25mg starting dose should be considered. Severe kidney problems – if you have severe renal impairment, a 25mg starting dose should be considered. A deformed penis – such as Peyronie's disease. Blood disorders – sickle cell anaemia, leukaemia, multiple myeloma. A stomach ulcer – sildenafil can sometimes aggravate an existing ulcer. A bleeding disorder – such as haemophilia. If you have any of these conditions, you may still be able to take sildenafil, but your doctor will need to start you on a lower dose (25mg) and monitor you carefully.

Store below 25°C (room temperature) in a dry place, away from direct sunlight and heat. Keep the blister pack or bottle in its outer carton to protect it from moisture. Keep the medicine out of the sight and reach of children. Do not use the tablets after the expiry date printed on the packaging. The active ingredient becomes less effective over time. If you have any leftover tablets, do not throw them away in household waste or pour them down the sink. Take them to your local pharmacy, where they will be disposed of safely.