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Viagra (Sildenafil)

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Sildenafil is a vasoactive agent used to treat erectile dysfunction and reduce symptoms in patients with pulmonary arterial hypertension (PAH). Sildenafil elevates levels of the second messenger, cGMP, by inhibiting its breakdown via phosphodiesterase type 5 (PDE5). PDE5 is found in particularly high concentrations in the corpus cavernosum, erectile tissue of the penis. It is also found in the retina and vascular endothelium. Increased cGMP results in vasodilation which facilitates generation and maintenance of an erection. The vasodilatory effects of sildenafil also help reduce symptoms of PAH.

Other names for this medication:
Caverta, Intagra, Kamagra, Penegra, Revatio, Silagra, Sildenafil, Sildenafila, Sildenafilo, Sildenafilum, Sildigra, Suhagra, Veega, Zenegra

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Also known as: Sildenafil


Viagra is the brand name for sildenafil citrate and is used to treat erectile dysfunction and pulmonary arterial hypertension.

Originally developed by scientists in the United Kingdom, it was brought onto the market by Pfizer Inc., an American pharmaceutical company.

Viagra can help men who cannot achieve or sustain an erection due to erectile dysfunction. It improves the erectile response when a man is already sexually stimulated, but it does not provide sexual stimulation. If there is no sexual stimulation, viagra will not work.

When sexual stimulation occurs, nitric oxide is released by the nervous system in the erectile tissue of the penis. Nitric oxide stimulates an enzyme that produces messenger cyclic guanosine monophosphate (cGMP).

cGMP causes the arteries in the penis to dilate, so that the arteries and the erectile tissue fill with blood. An erection results.

Viagra prevents cGMP from becoming degraded, so the blood flow and the erection can continue.


Take Viagra exactly as it was prescribed for you. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Viagra is usually taken only when needed, 30 minutes to 1 hour before sexual activity. You may take it up to 4 hours before sexual activity. Do not take Viagra more than once per day.

Viagra can help you have an erection when sexual stimulation occurs. An erection will not occur just by taking a pill. Follow your doctor's instructions.

During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect of sildenafil.

Store at room temperature away from moisture and heat.

Detailed Viagra dosage information


In studies with healthy volunteers of single doses up to 800 mg, adverse reactions were similar to those seen at lower doses but incidence rates and severities were increased.

In cases of overdose, standard supportive measures should be adopted as required. Renal dialysis is not expected to accelerate clearance as sildenafil is highly bound to plasma proteins and it is not eliminated in the urine.


Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) and away from excess moisture and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Viagra are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.


Viagra can interact with several other medications. Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Viagra and other medications

Below are lists of medications that can interact with Viagra. These lists don’t contain all the drugs that may interact with Viagra.

Before taking Viagra, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Viagra and other ED medications

You shouldn’t take Viagra with any other medications for erectile dysfunction (ED). This includes prescription medications, such as:

  • tadalafil (Cialis)
  • avanafil (Stendra)
  • vardenafil (Levitra, Staxyn)
  • alprostadil (Muse, Caverject, Caverject Impulse, Edex)
It also includes natural or over-the-counter ED treatments, such as l-arginine and yohimbine.

Taking Viagra with other ED medications increases your risk of certain side effects, such as low blood pressure and priapism.*

If you’re using Viagra, don’t use any other medications for ED without talking with your doctor.

* Priapism is a long-lasting and sometimes painful erection that doesn’t go away. It’s a medical emergency because it can damage the tissues in your penis and lead to permanent ED.

Viagra and nitrates

You shouldn’t take Viagra with nitrate drugs. This includes certain prescription drugs, such as nitroglycerin, used to treat angina (a type of chest pain). It also includes certain illicit drugs called poppers, such as amyl nitrate.

Taking Viagra with nitrates can cause a dangerous drop in your blood pressure that can lead to heart attack or stroke.

Examples of nitrate drugs that should not be taken with Viagra include:

  • nitroglycerin (Nitromist, Nitro-Dur, Nitrolingual Pumpspray, Gonitro, others)
  • isosorbide mononitrate (Monoket)
  • isosorbide dinitrate (Dilatrate SR, Isordil)
  • glyceryl trinitrate
  • amyl nitrate
  • alkyl nitrate
  • butyl nitrate

Viagra and drugs for pulmonary arterial hypertension

You shouldn’t take Viagra if you’re taking the pulmonary arterial hypertension (PAH)* drugs listed below. Taking Viagra with these medications can cause your blood pressure to drop too low.

Examples of drugs used to treat PAH that should not be taken with Viagra include:

  • riociguat (Adempas)
  • sildenafil (Revatio)
  • tadalafil (Adcirca)
* With PAH, you have <em>high blood pressure</em> in the artery between your heart and lungs.

Viagra and blood pressure drugs

Viagra can sometimes cause low blood pressure. Taking Viagra with drugs used to treat high blood pressure can cause your blood pressure to drop even lower.

Examples of drugs used to treat high blood pressure include:

  • calcium channel blockers, such as amlodipine (Norvasc)
  • beta-blockers, such as metoprolol (Lopressor, Toprol-XL)
  • ACE inhibitors, such as lisinopril (Zestril, Prinivil)
  • angiotensin II receptor blockers, such as losartan (Cozaar)
If you take a drug for high blood pressure, your doctor might prescribe a dose of Viagra for you that’s lower than the typical dose.

Viagra and alpha-blockers

If you’re taking a type of blood pressure drug called an alpha-blocker, the extra drop in blood pressure from Viagra could make you feel dizzy or lightheaded. It could even make you faint. If you’re taking an alpha-blocker, your doctor will recommend a starting dose of 25 mg of Viagra, which is lower than the usual starting dose.

Examples of alpha-blocker drugs used for high blood pressure include:

  • doxazosin (Cardura)
  • prazosin (Minipress)
  • terazosin
If you take one of the drugs listed above, tell your doctor if you feel dizzy or lightheaded, or faint after taking Viagra.

Viagra and illicit drugs

You shouldn’t take Viagra with illicit drugs called poppers. Poppers contain nitrate drugs such as amyl nitrate, alkyl nitrate, and butyl nitrate. Taking Viagra with poppers can cause a dangerous drop in your blood pressure that can lead to heart attack or stroke.

Viagra hasn’t been tested for use with illicit drugs other than poppers. But it’s possible that taking Viagra with certain other illicit drugs could also have dangerous effects on your heart and blood pressure.

Examples of illicit drugs that could have dangerous effects if taken with Viagra include:

  • stimulants, such as cocaine, ecstasy, amphetamines, and speed
  • anabolic steroids
If you’re thinking of using illicit drugs with Viagra, talk with your doctor about whether this is safe for you to do.

Viagra and certain BPH drugs

Viagra can sometimes cause low blood pressure. Certain drugs used to treat benign prostatic hyperplasia (BPH)* can also cause low blood pressure. These drugs are called alpha-blockers.

Taking Viagra with alpha-blockers can cause your blood pressure to drop even lower. This could make you feel dizzy or lightheaded, or even cause you to faint.

Examples of alpha-blockers that are used to treat BPH include:

  • alfuzosin (Uroxatral)
  • doxazosin (Cardura)
  • tamsulosin (Flomax)
  • silodosin (Rapaflo)
  • terazosin
If you’re taking an alpha-blocker, your doctor will recommend a starting dose of 25 mg of Viagra, which is lower than the usual starting dose. And if you take one of the drugs listed above, tell your doctor if you feel very dizzy, lightheaded, or faint after taking Viagra.

* With BPH, you have an enlarged prostate.

Viagra and Adderall

Viagra hasn’t been tested for use with Adderall, so it’s not known what effects the drugs would have if taken together. But that doesn’t mean there wouldn’t be an interaction.

Adderall, which contains amphetamine salts, is approved to treat attention deficit hyperactivity disorder (ADHD). Adderall has stimulant effects in your body, and it could cause serious heart-related side effects.

Viagra, on the other hand, may cause low blood pressure. So it’s possible that taking it with Adderall could have dangerous effects on your heart or blood pressure.

If you take Adderall, ask your doctor if it’s safe for you to take Viagra as well.

Viagra and Xanax

Viagra hasn’t been tested for use with Xanax, so it’s not known what effects the drugs would have if taken together. But that doesn’t mean there wouldn’t be an interaction.

Xanax, which is a benzodiazepine, contains the active drug alprazolam. Xanax can sometimes cause low blood pressure, dizziness, and fainting. Viagra may also lower your blood pressure. So it’s possible that taking it with Xanax could have dangerous effects on your heart or blood pressure.

If you take Xanax, ask your doctor if it’s safe for you to take Viagra as well.

Viagra and antidepressants

It’s usually fine to take Viagra with antidepressants. It’s important to note that erectile dysfunction (ED) is a common side effect of certain antidepressants. This is particularly true for selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft). And Viagra is sometimes prescribed to treat ED that’s caused by antidepressants.

If you have questions about whether you can take Viagra with an antidepressant, talk with your doctor.

Viagra and certain antimicrobials

Taking Viagra with certain antimicrobials (drugs used to treat infection) can slow the breakdown of Viagra in your body. This can cause Viagra to build up inside your body, which may increase your risk of side effects from the drug.

Examples of antimicrobial drugs that can increase the risk of side effects from Viagra include:

  • certain antibiotics, such as:
    • clarithromycin
    • erythromycin
    • telithromycin (Ketek)
  • certain antifungals, such as:
    • ketoconazole (Nizoral)
    • itraconazole (Sporanox)
    • posaconazole (Noxafil)
    • voriconazole (Vfend)
  • certain antivirals used for HIV, such as:
    • atazanavir (Reyataz)
    • cobicistat (Tybost)
    • ritonavir (Norvir)
    • indinavir sulfate (Crixivan)
    • nelfinavir mesylate (Viracept)
    • saquinavir mesylate (Invirase)
If you take one of the drugs listed above, your doctor will recommend you take a starting dose of 25 mg for Viagra. (This is lower than the typical starting dose of Viagra.) And if you take ritonavir, you shouldn’t take more than one 25-mg dose of Viagra within a 48-hour period.

Viagra and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Viagra. However, you should still check with your doctor or pharmacist before using any of these products while taking Viagra.

Viagra and foods

There aren’t any foods that have been specifically reported to interact with Viagra. If you have any questions about eating certain foods with Viagra, talk with your doctor.

Viagra and grapefruit

Grapefruit juice can affect the levels of some medications in your body. But there’s not much evidence to show that the fruit or its juice can affect Viagra levels.

One small study was done in 2002. It showed that drinking grapefruit juice with Viagra slightly increased people’s blood level of the drug. This could possibly increase the risk of certain side effects such as headaches, flushing, or dizziness. But these side effects weren’t specifically reported in the study.

If you want to drink grapefruit juice or eat grapefruit while you’re taking Viagra, talk with your doctor. They can recommend whether this is safe for you to do. If you do have increased side effects with this combination, try avoiding grapefruit while you’re taking Viagra.

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This study was undertaken to examine the immunosuppressive effects of bone marrow (BM)-derived DCs genetically modified to express IDO, and of exosomes derived from IDO-positive DCs. HIV-infected patients with suppressed viral replication had increased level of microbial translocation as measured by LPS. We develop mathematical models of the transmission and evolution of multi-strain pathogens that incorporate strain extinction and the stochastic generation of new strains via mutation. Many low-and middle-income countries (LMIC) of the World Health Organization (WHO) European Region have introduced social health insurance payroll taxes after the political transition in the late 1980s, combined with budget transfers to allow for exempting specific population groups from paying contributions, such as those outside formal sector work and in particular vulnerable groups. An ethanolic extract of the roots of Barringtonia racemosa afforded two novel neo-clerodane-type diterpenoids, methyl-15, 16-epoxy-12-oxo-3,13(16),14-neo-clerodatrien-18, 19-olide-17-carboxylate (nasimalun A, 1) and dimethyl-15,16-epoxy-3, 13(16),14-neo-clerodatrien-17,18-dicarboxylate (17-carboxymethylhardwickiic acid methyl ester, nasimalun B, 2) by NMR and MS analyses and by comparison of their spectral data with related compunds. Influence of cultivar and harvest year on the volatile profiles of leaves and roots of carrots (Daucus carota spp.

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Other melanocytic markers included MiTF (12/14) and MelanA (2/12). We performed a community-based study of people aged 70 years and over in 12 randomly selected villages in the rural Hai district of Tanzania. Bilateral gangrene of the feet associated with Salmonella infection in children with sickle cell anaemia. Appropriate instruments were used for measurement and statistic analysis was subsequently performed. Alcohol synergistically enhances the progression of liver disease and the risk for liver cancer caused by hepatitis C virus (HCV). Adenylyl imidodiphosphate (AMP-PNP) was used as the reaction substrate and strontium was used as the capture ion for the liberated phosphate.

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To investigate the fluctuations of directly measured intraocular pressure (IOP) and induced diastolic ocular perfusion pressure (DOPP) during three simulated steps of phacoemulsification in vivo. Overall, these studies suggest the SCIB provides a reliable and comprehensive measure of support and control in birth. The goal of this study was to clarify the role of hyaluronan in interstitial pneumonia. These results suggest that bile acid-activated FXR is able to induce FGF19 in hepatocytes to inhibit CYP7A1 by an autocrine/paracrine mechanism. It is presumed that the living environment played an important role in determining the codon usage pattern of these microorganisms. A procedure of combined modifications is recommended for exploration of non-abundant antigens or for achieving a high-quality photograph. Fluorescence microscopy of expression plasmid-transfected cells demonstrated that the residues 28 to 32 formed the core nuclear localization signal, but other adjacent positively-charged residues augmented these sequences.

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In comparison to a common floral odor (phenylethyl alcohol), Hedione exhibited significantly enhanced activation in limbic areas (amygdala, hippocampus) and elicited a sex-differentiated response in a hypothalamic region that is associated with hormonal release. The goal is to restore thoracic volume, symmetry, and function and to allow for growth of the thorax in skeletally immature children. Model spironolactone aldactone 50 mg tablet Purkinje cells that receive parallel fiber inputs from neurons in the granular layer learn to stop eliciting spikes at the timing instructed by the arrival of signals from the inferior olive. VBG is the procedure of choice because of proven efficacy and has the benefit over gastric bypass of not producing malabsorption. 30 patients with refractory recurrent hypermenorrhea were included in a prospective controlled comparative study. This procedure forces the reader into an incremental mode of processing in which each word must be fully integrated with the preceding context before the next word can be considered. A number of recent patents and patent applications have been published that discuss some of these discoveries.

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Epithelial ovarian cancer (EOC) is the most lethal disease among gynecologic malignancies. In addition HSP are also involved in several processes essential for cellular function under physiological conditions. In adult patients with highest dose of xanax acquired immunodeficiency syndrome (AIDS), cerebral arteritis usually takes the form of arterial wall thickening, stenosis, and occlusion, leading to cerebral ischemia and infarction. PRL mRNA expression, on the other hand, was largely unchanged after parturition. Stretchable, weavable coiled carbon nanotube/MnO2/polymer fiber solid-state supercapacitors. Genital melanocytic naevus on lichen sclerosus: an uncommon occurrence and a management proposal.

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This paper presents the fabrication, assembly, and characterization of piezoresistive nanosprings for creating nanoelectromechanical systems. SLE developed in a preadolescent child with Klinefelter syndrome who had no detectable sex hormone. Changes in Dact1 expression were investigated in three in vitro models of adipogenesis. The roles of multi-drug resistance protein 1 (MDR1), multi-drug resistance related protein 1 (MRP1), lung resistance protein (LRP) and breast cancer resistance protein (BCRP) in the multi-drug resistance (MDR) of hepatocellular carcinoma (HCC) were studied. Mouse interferon (MuIFN) strongly suppressed the growth of human nasopharynx carcinoma (KB) transplanted into nude mice when given by subcutaneous injection around the tumor, though KB cells were insensitive not only to the antiproliferative activity of MuIFN, but also to natural killer (NK) activity in vitro. Our case further confirms the potential for Capnocytophaga to cause systemic infections, highlights the availability and need for identification of isolates to species level and re-emphasises the difficulty in diagnosing Capnocytophaga infections due to their slow growth in the laboratory. These data reveal that the mitogen-activated protein kinase/extracellular signal-regulated kinase inhibitor trametinib attenuates systemic inflammation and multiple organ damage in a clinically relevant model of sepsis. Both granulomas and exudates were rich in germinated conidia and hyphae. The nicotine receptor antagonist alpha4beta2 rather than alpha7 showed a dose-dependent antagonistic action on the effect of nicotine on running speed. For instance, age information can exclude alternative (i) above and also indicate that alternative (iii) is apriori more likely than alternative (ii).

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Rapid Identification of Steroidal Saponins in Trillium tschonoskii Maxim by Ultraperformance Liquid Chromatography Coupled to Electrospray Ionisation Quadrupole Time-of-Flight Tandem Mass Spectrometry. Long-term prognosis of transient acute myocardial ischemia at rest. The number of Waf1p21-positive cells slightly increased from normal to basal cell hyperplasia (BCH), but did not further increase in DYS and SCC. Antibody to a cryptic, solid phase C1Q antigen in membranoproliferative nephritis. To develop a methodology for evaluating the impact of research on health care, and to characterise the papers cited on clinical guidelines. Deletion of 29 amino acids in the Bax N-terminus (Bax 30-192) caused constitutive accumulation at mitochondria and triggered high levels of cytotoxicity, not inhibited by Bcl-xL. In particular, the use of a monitoring set with neural networks does not always prevent overfitting. Real-time evaluation of individual cow milk for higher cheese-milk quality with increased cheese yield. Pure midbrain stroke patients who presented with isolated unilateral oculomotor paresis were identified from a group of 2447 consecutive patients hospitalized for acute cerebral infarction or hemorrhage during the period May 2008 through April 2014. In this paper, a nonlinear modeling technique is proposed to demonstrate the possible mechanisms of interaction between sensory paths.

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Herein, we report a case of HDR syndrome associated with nephrocalcinosis and distal renal tubular acidosis. Pregnancy increases the risk of mechanical heart valve (MHV) thrombosis. We included 49 patients with T3/4 stage adenocarcinoma (diagnosis confirmed by clinical, pathological and CT examinations) of the lower two thirds of the rectum, who were treated with long-term radiotherapy (45 Gy in 20-25 fractions) and questioned for the presentation of symptoms before and after the treatment. Following hip arthroplasty, these methods have been used to plan for revision arthroplasty and to evaluate the contralateral side for avascular necrosis. In isolated perfused lungs, CP interferes with pulmonary clearance of 5-hydroxy tryptamine (5 albenza 200 mg tablet -HT) and norepinephrine.

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Hemodilution with dextran during experimental acute myocardial infarction: increase of the flow in the ischemic area. Nontarget effects of chemical pesticides and biological pesticide on rhizospheric microbial community structure and function in Vigna radiata. The possible advantages of the minimally invasive approach included earlier extubation and earlier discharge from the hospital. A self-assembled monolayer incorporating a complementary backbone structure between chemisorbed and crystallizing molecules of 4-hydroxybiphenyl favors its crystallization in a new monoclinic crystal packing arrangement. For FRET microscopy to reach its full potential, it must be able to image more than one pair of interacting molecules and image degradation from out-of-focus light must be reduced. On day 28 of experimental DM, the decrease in NSC numbers in the VMN was observed in the animals of both age groups because of apoptosis and hydropic degeneration.

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