Viagra (Sildenafil)

Viagra is an erectile dysfunction treatment that works by increasing blood flow to your penis. When you are sexually aroused, Viagra allows you to get and keep an erection.

Viagra blocks PDE-5 (phosphodiesterase type 5) enzymes in your penis so that your blood vessels get wider. This helps you get enough blood in your penis for an erection to happen.

To take Viagra, you should swallow 1 tablet whole with a glass of water or juice, 1 hour before you have sex. You should only take Viagra once a day. Wait at least 24 hours before you take it again, or any other erectile dysfunction medicine.

You can take Viagra on an empty stomach, though you should avoid:

• grapefruit juice
• high fat food, as Viagra may take longer to work or not work as well
• alcohol, for better results, as this can slow down getting an erection

It takes Viagra between 30 to 60 minutes to work after you take the tablet. You must be aroused before you have sex for Viagra to work. To make sure Viagra works at its best, you should not drink alcohol or have a large, fatty meal before you take your tablet.

Viagra usually lasts between 4 and 6 hours after you take a tablet, so you can get more than one erection during this time.

Although rare, if you get an erection that lasts longer than 4 hours, you might have priapism. You need to call 999 straight away for help.

There are three different doses of Viagra, starting from 25mg and going up to 50mg and 100mg. To use Viagra safely, you should not take more than 1 tablet a day.

Your doctor will generally prescribe you 50mg Viagra tablets to start off with. But if you are on certain types of treatments (such as for HIV or blood pressure), your doctor may suggest you try a lower dose, of 25mg.

If the 50mg tablet is not working for you, let your doctor know. They may increase the amount of Viagra you need to take, to 100mg.

You can take Viagra if you are over 18 years old and need help getting or maintaining an erection. If you think you have erectile dysfunction, you will need to speak to a doctor before you use Viagra.

You should not take Viagra if you’ve:

• had a heart attack or stroke
• got kidney, heart, or liver problems
• got a rare inherited eye disease such as retinitis pigmentosa
• ever had an allergic reaction to Viagra or a similar medicine in the past
• got low blood pressure
• been prescribed nitrates to treat chest pain

You’ll need to speak to a doctor before you take Viagra if you have:

• an irregular penis shape or a curved penis (Peyronie’s disease)
• heart problems
• a stomach ulcer or bleeding problems like haemophilia
• sickle cell anaemia
• cancer

Common side effects

The most common side effects of Viagra should settle within the first few minutes after you take it. If you experience any side effects for longer, it may be worth changing your dose or talking to your doctor.

The most common side effects of Viagra include:

• headaches
• stuffy nose
• blurry vision
• rash
• feeling dizzy or faint
• face flushing
• indigestion
• back or muscle pain

Uncommon and rare side effects

Uncommon side effects of Viagra include:

• chest pains during or after sex
• prolonged (more than 4 hours) and painful erections
• skin reactions, such as swelling or peeling of the skin, or blistering around the mouth
• changes in vision
• seizure

It’s rare, but possible, that you could have an allergic reaction to Viagra. These symptoms would include:

• swollen mouth, lips, tongue, or face
• itchy, swollen, or peeling skin
• wheezing or tightness in your throat
• trouble breathing or talking

If you experience any of these side effects, you should stop taking Viagra and call 999 immediately.

You can buy Viagra online from a pharmacy registered with the GPhC, like ZAVA Online Doctor. Before we can send you a pack of Viagra in the post, a doctor will check your answers to our online questionnaire and make sure it is safe for you to take.

There are many alternatives to Viagra to treat your erectile dysfunction. These can be other medicines or non medical alternatives.

Medical alternatives to Viagra

There are medical alternatives to Viagra, such as tablets, creams, or injections.

Viagra is also available as both a generic pill called Sildenafil, and as an over the counter medication called Viagra Connect.

Other tablets which are similar to Viagra, and work in the same way, include:

• Cialis, which usually costs more, but lasts much longer (up to 36 hours) than Viagra
• Cialis Daily, which is a small dose you should take at the same time once a day, so you can be ready to have sex more often and avoid side effects
• Tadalafil, which is a cheaper (non-branded) version of Cialis and has the same long lasting effect (36 hours)
• Levitra, which is very similar to Viagra but works faster (within 25 to 60 minutes)
• Spedra, which starts working quicker (within 30 to 45 minutes) than Viagra

There are also medical alternatives that come as a cream, such as alprostadil (Vitaros), or injections.

Non medical alternatives

Non medical alternatives to Viagra include lifestyle changes, such as drinking less alcohol, quitting smoking, or losing weight. You can also try:

• pelvic floor exercises, which can help build up the muscles around your penis and allow blood to flow there more easily
• sex therapy, which can help if your erectile dysfunction is caused by your mental health
• vacuum pumps, which use air pressure to get blood to your penis, though you should not use a pump for more than 30 minutes
• penile implants, which can be surgically placed inside your penis

There are no natural or herbal remedies that work in the same way as Viagra.

Can Viagra become less effective over time?

Viagra can become less effective over time due to changes in your body or your health. If this happens, you can switch to an alternative option (medical or non-medical). If you find that Viagra is no longer working for you, speak to a doctor for a health check.

Can you drink alcohol when taking Viagra?

Yes, you can drink alcohol when taking Viagra, but you should limit how much you have. Large amounts of alcohol may make it difficult to get an erection, so you should avoid having more than 3 units of alcohol per day.

What happens if a woman takes Viagra?

If a woman takes Viagra, they will experience side effects, such as headaches and low blood pressure or dizziness. They will need to speak to a doctor for advice and tell them that they have taken Viagra.

Women should not take Viagra. It does not cause sexual stimulation or increase the likelihood of an orgasm in women.

If you are a woman, you should only take Viagra if a doctor prescribes it for you to treat a specific health reason, like pulmonary hypertension.

Is Viagra bad for the heart?

Viagra is not bad for the heart if you have a healthy heart.

But, if you are taking Viagra and are on heart medication, you should talk to your doctor for regular health checks. Unless your doctor tells you not to, you can take it with your heart medication.

Will Viagra make your erection bigger?

Viagra will not make your erection bigger. It might feel like it does, but that’s because you have more blood flowing into your penis. This extra blood flow is how Viagra helps you get and keep an erection.

If you want a bigger erection, you might consider increasing your penis size. To get a bigger penis, you’ll need to look at getting cosmetic surgery. You can discuss this with your doctor.

Can you take Viagra with other erectile dysfunction treatments?

You should not take Viagra with any other erectile dysfunction treatments or medication.

If your Viagra tablet does not work, do not take another Viagra tablet or a different tablet on the same day. Speak to your doctor for advice.

Taking more than 1 type of erectile dysfunction medication can harm your health. If you want to try a different erectile dysfunction tablet, speak to your doctor.

Sometimes your Viagra tablet might not work after you take it, and you can try again the next day. It might be because you had a lot of alcohol to drink, or had a high fat meal that day. You’ll need to make sure you are sexually stimulated too, otherwise Viagra will not work.

Should Viagra be taken on an empty stomach?

You can take Viagra on an empty stomach, but you do not have to. Viagra may take longer to work if you take it with or after food, especially if there is a lot of fat in your meal or snack.

Can you buy Viagra without a prescription?

If you want to buy Viagra as a 25mg, 50mg or 100mg tablet, you need a prescription. At ZAVA, we help make the process easier and faster, so you can get Viagra online after approval by one of our doctors.

You can order Viagra Connect from ZAVA after a consultation with a doctor, or at a pharmacy without a prescription after speaking to a pharmacist. Viagra Connect is an over the counter version of Viagra, though it is only available as a 50mg tablet.