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[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.

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[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 within twenty minutes and lasts for about two hours. Common side effects include headaches, heartburn, and flushed skin. [8] lovegra 100 mg 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.

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[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. [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. [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.

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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 generally in Raynaud's was not clear. Sildenafil has shown some potential for improving exercise performance at high altitudes.

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Medicines in this group include avanafil (Stendra), sildenafil (Viagra, Revatio, and others), tadalafil (Cialis and others), and vardenafil (Levitra, Staxyn). Use an accurate measuring device to measure your dose of sildenafil oral liquid. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device. Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

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This will help them determine if sildenafil is right for you. In particular, make sure that you discuss any of the following. Tell your healthcare provider if you have any of the following. Heart problems, such as heart rhythm problems, chest pain, or heart failure Heart attack, stroke, or heart surgery within the past six months High blood pressure that is still too high despite taking medicines for it Peyronie's disease, or a penis with an abnormal curve or shape An erection lasting longer than four hours A blood disorder, such as sickle cell anemia An inherited eye disease called retinitis pigmentosa Vision loss, or a problem with the nerve between your eyes and brain (optic nerve) Health conditions or factors that raise the risk of optic nerve problems, such as diabetes, high cholesterol, smoking, being older than 50, or having a “crowded disc,” which is something an eye doctor may see in an eye exam Pulmonary veno-occlusive disease, a condition where blood vessels in the lungs are blocked It is not known if or how sildenafil could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. 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. 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).

Ingredient	Quantity per Tablet	Source	Quality Assurance Level
Sildenafil Citrate	200mg	Pharmaceutical Grade	Approved by Health Canada
Fillers	As specified	Food-grade	Certified
Binders	As specified	Pharmaceutical Suppliers	Quality Tested
Colorants	As needed	FDA-approved dyes	Verified authenticity

[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. 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.

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"[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.

Side Effect	Incidence Rate	Severity	Recommendations	Duration
Headache	Common	Mild	Hydration, pain relievers	Few hours
Flushing	Common	Mild	Cooling measures	Few hours
Nasal Congestion	Moderate	Mild	Decongestants	Few hours
Dizziness	Less Common	Mild	Rest, sit down	Few hours
Vision Changes	Rare	Moderate	Seek medical advice	Variable

Rare but serious adverse effects found through postmarketing surveillance include prolonged erections, severe low blood pressure, myocardial infarction (heart 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.

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If you or someone else has used too much sildenafil, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222. For this use, sildenafil is used only when needed. Take it as your healthcare provider recommends, which is usually between 30 minutes to four hours before planned sexual activity. Do not take double or extra doses. For this use, take sildenafil as your healthcare provider recommends, which is usually three times a day.

Safety Advice

If it is almost time for your next dose, skip the missed dose and only take the next dose. Ask your healthcare provider if you are unsure what to do after a missed dose. This survey is being conducted by the WebMD marketing sciences department. [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. 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. [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. 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. 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.

• Emergency: If you have an erection lasting more than 4 hours, go to ER.
• This condition (priapism) can cause permanent damage if untreated.
• Symptoms of heart attack: chest pain, shortness of breath, nausea.
• Seek immediate help if you experience sudden vision loss.
• Hearing loss is rare but requires prompt medical evaluation.
• Allergic reactions: hives, difficulty breathing, swelling.
• Keep emergency contact numbers handy.
• Do not drive if you feel faint or dizzy after taking the pill.

Sildenafil's popularity with young adults has increased over the years.

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• Some men may experience a headache, nasal congestion, or upset stomach.
• Cenforce is not suitable for individuals with certain medical conditions or allergies.
• Inform your doctor of all medications to prevent adverse interactions.
• Use Cenforce only as part of a comprehensive treatment plan for ED.
• It is not intended for use as a recreational drug.
• Combining Cenforce with other ED drugs is not recommended.
• The medication should be part of a healthy lifestyle that includes exercise.
• Seek immediate medical attention if you experience chest pain or vision changes.

[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.

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Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take sildenafil while breastfeeding. If you take sildenafil after you eat a high-fat meal, such as a burger and fries, it may take longer to start working. Your healthcare provider may recommend limiting or avoiding grapefruit while taking sildenafil. Grapefruit or grapefruit juice can raise sildenafil levels in your body, which can increase the risk of side effects.

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There are no known interactions between sildenafil and alcohol. Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. In particular, make sure that you discuss if you are using any of the following before taking sildenafil. Tell your healthcare provider about all medicines that you take or have recently taken. This may not be a complete list of medicines that can interact with sildenafil. [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.

• Cenforce 200mg is a popular medication used to treat erectile dysfunction in men.
• It contains sildenafil citrate, the same active ingredient as Viagra.
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