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Frequently Asked Questions Concerning  Viagra®

What is Viagra®?

Viagra® is the first significant oral medication for the treatment of erectile dysfunction (ED).  The medicine was originally developed as a cardiovascular medicine designed to improve blood flow in the vessels of the heart.  However, during initial studies the medication was found to have a profound side effect.  Individuals began to report a remarkable difference in their ability to achieve and maintain an erection.  Further studies were completed and on March 27, 1998, the medication was approved by the FDA for the treatment of erectile dysfunction.              

How does Viagra® work?

Viagra® is dispensed as a pill and ingested orally.  Approximately 30-60 minutes later the drug is absorbed in the bloodstream.  Viagra® then functions as an inhibitor to an enzyme called phosphodiesterase type (PDE5) which is found primarily in the penis.  By inhibiting PDE5, smooth muscle in the penis remains relaxed for a longer period.  This allows for increased blood flow into the cavernous tissue of the penis thereby generating an erection.  Viagra is unique in that it increases a natural occurring process, therefore, only through sexual stimulation will an erection occur. 

What is the appropriate dose? 

The standard dose is 50mg one hour prior to sexual activity.  However, if you are older than age 65 or have a serious kidney or liver disease some physicians will recommend starting with the minimal dose of 25mg.  Viagra® should not be taken more than once per any 24-hour period and doses should not exceed 100mg.  The half-life of Viagra®, the time the drug remains effective after ingestion, is approximately four hours.  

What clinical studies have been done?

Viagra® was administered to more than 3000 patients (age 19-87 years) with erectile dysfunction of various etiologies (organic, psychogenic or mixed) with a mean duration of 5 years.  Viagra® demonstrated statistically significant improvement as compared to a placebo in all studies.  In one particular study concerning the frequency of successful penetration during sexual activity and maintaining erection after penetration, 83% of these patients reported an improved erection on Viagra® verses 12% on a placebo medication. 

How much time must surpass before Viagra is effective?

Viagra is rapidly absorbed.  Maximum observed plasma concentrations are reached within 30 to 120 minutes (median time 60 minutes) of oral dosing on an empty stomach.  Note: when Viagra is taken with a high fat content meal, the rate of effectiveness can be significantly diminished.

What happens if there is no sexual stimulation following the ingestion of Viagra®?

Viagra® is naturally eliminated from your body in a few hours.

What are the side effects of Viagra®?

• The side effects of Viagra® are relatively few and if they do occur, they are usually short lived.  However, some patients have reported the following side effects:
• Congestion
• Diarrhea
• Facial Flushing
• Headaches
• Urinary Tract Infections
• Visual Changes (mild and temporary changes in blue/green colors or increased sensitivity to light)  

What are precautions/warnings concerning Viagra®?

Men who are taking medicines that contain nitrates (Nitroglycerin) of any kind must never use Viagra®.  Patients should not take Viagra® even if you only take nitroglycerin medication occasionally.  (Please see list of nitrates)  There is also a potential for cardiac risk during sexual activity in patients with preexisting cardiovascular disease.  Therefore, Viagra® should not be used in men where sexual activity is inadvisable because of their underlying cardiovascular status.  Several medications are known to interact with Viagra®.  Therefore, one should inform their physician concerning all medications they are taking, including those medications acquired by a prescription as well as over the counter medicines.  The use of Viagra® offers no protection against sexually transmitted diseases, including HIV.  Patients should continue to use protective measures necessary to guard against these diseases.  In case of an overdose, call your physician immediately.

Can I use Viagra with other medications?

Yes, it is generally safe to use Viagra while on other medications, however some medicines may potentiate the effects of Viagra®.  Individuals should always consult with their healthcare provider prior to taking any medication.  Note Viagra does have one absolute contraindication; individuals who are taking medication-containing nitrate (even intermittently) should not take Viagra.

Why is Viagra absolutely contraindicated in individuals who are currently taking medications containing nitrates?

Viagra® has been shown to potentiate the hypotensive effects of nitrates to life threatening levels.  Therefore, individuals who are currently using nitrates in any form even intermittently should not take Viagra®.  Nitrates are available in many medications; sprays, ointments, skin patches, pastes and tablets dissolved in the mouth.  Nitrates are also found in illicit drugs such as amyl nitrate or nitrite "Poppers".  If you are unsure if you are currently taking nitrates please value your health and consult with your local physician or pharmacist. 

Can I get Viagra® over the counter?

No, Viagra® should only be taken by prescription from a licensed physician.  FDA regulations do not permit Viagra® to be taken without prescription.  CLICK HERE for a consultation for a Viagra® prescription.  A Licensed Physician will review your medical history and patient profile.  If approved for a Viagra® prescription, we will have your order shipped discretely to your home or office. 

For what types of ED is Viagra proving to be especially effective? 

Viagra® is showing optimal results in individuals who experience ED secondary to high levels of anxiety (performance anxiety) and individuals with mild ED. 

Is Viagra less effective in treating ED that is secondary to certain underlying medical conditions?

This question is somewhat difficult to answer right now.  More data is expected in the near future.  Some initial data suggests that men, who have undergone radical prostatectomy (surgical removal of their prostate), using nerve-sparing procedures, are not achieving the same positive results with Viagra. 

Can Viagra® be combined with other treatments for erectile dysfunction?

The use of such combined treatments is not recommended, since no studies have been done to access Viagra's® safety and effectiveness.

Is there a potential for Viagra to be used in the treatment of ED in women?

There are currently several medical research centers that are studying whether Viagra is a viable oral therapy for woman with ED.  The problem is, secondary to anatomy, we know less concerning female ED than male ED. Historically, research has focused on male ED.  Until we have a better understanding of the physiological processes causing Ed in women are ability to treat the condition is limited.  Although some physicians are prescribing Viagra to their female patients, it is important to note, the FDA has not approved the medication for the treatment of ED in women. 

Viagra® is a prescription medicine used to treat erectile dysfunction.  Only a physician should decide if it is appropriate for you.  These pages are only a summary.  If you have further questions or would like more information about Viagra®, consult you personal physician or pharmacist.  Information can also be obtained by visiting Pfizer at call 1-888-4VIAGRA.

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