Sildenafil (Generic Viagra)

Sildenafil blocks an enzyme called PDE5 that breaks down cGMP, a molecule that relaxes smooth muscle and allows blood flow into the penile tissue. By blocking PDE5, the medication lets cGMP accumulate, promoting blood vessel dilation and increased blood flow during sexual stimulation. This helps achieve and maintain erections. The medication requires sexual stimulation to work. It enhances your natural response but doesn’t create erections without arousal.

Sildenafil typically begins working within 30 to 60 minutes on an empty stomach, with peak effectiveness around 60 to 90 minutes. Taking it with a large or high-fat meal can delay absorption by 30 to 60 minutes. Some men respond faster, within 20 to 30 minutes, while others need closer to 90 minutes. Effects last approximately 4 to 6 hours. For best results, take the medication 60 minutes before the planned activity, on an empty or lightly full stomach.

Sildenafil doses typically range from 25mg to 100mg, with 50mg being the standard starting dose. We customize dosing based on your response, side effects, medical history, and other medications. Some men achieve excellent results with 25mg, while others need higher doses. Our compounded formulations at 55mg and 110mg allow precise dosing. Start with an appropriate dose and adjust based on experience, rather than jumping to the maximum.

Common side effects include headache, facial flushing, nasal congestion, upset stomach, and temporary, mild visual changes such as a bluish tint or light sensitivity. These are typically mild and resolve within a few hours. Serious but rare side effects include prolonged erection lasting over 4 hours (priapism, which requires immediate medical attention), sudden vision loss, or sudden hearing loss. Most men tolerate the medication well, and side effects often decrease with continued use.

Sildenafil interacts with certain medications. Most critically, nitrates like nitroglycerin used for chest pain can cause dangerous blood pressure drops when combined with sildenafil. This combination is contraindicated. Alpha-blockers for prostate or blood pressure may also interact, requiring dose adjustments and careful timing. Some antifungals, antibiotics, and HIV medications affect sildenafil metabolism. Disclose all medications during your consultation so we can screen for interactions.

Yes, the medication can be effective for erectile dysfunction related to diabetes, though response rates may be slightly lower due to vascular and nerve damage from diabetes. Blood sugar control significantly impacts effectiveness. Better-controlled diabetes typically results in better sildenafil response. Some diabetic men need higher doses for optimal results. Combining sildenafil with diabetes management, cardiovascular health, and testosterone optimization if levels are low can improve overall effectiveness.

Small amounts of alcohol, 1 to 2 drinks, are generally acceptable with the medication, but excessive alcohol can reduce effectiveness and increase side effects. Alcohol is a vasodilator and central nervous system depressant, both of which can impair erectile function and counteract sildenafil’s benefits. Heavy drinking also increases the risk of dizziness and blood pressure changes. For best results, limit alcohol when planning to use sildenafil.

Several factors can reduce effectiveness: insufficient dosage, poor timing (taking too soon or too long before activity), taking with food (which delays absorption), inadequate sexual stimulation, psychological factors such as performance anxiety, underlying health conditions not addressed (low testosterone, cardiovascular disease, diabetes), or medication interactions. If sildenafil isn’t working, we can adjust the dose, try different timing, address underlying issues such as hormone optimization, or consider alternatives such as tadalafil, vardenafil, or Trimix.

Yes. Generic sildenafil contains the same active ingredient as brand-name Viagra and is equally effective when properly manufactured. Our compounded medication is prepared by FDA-registered pharmacies in accordance with USP quality standards. The active pharmaceutical ingredient is identical. The difference is in price. Compounded sildenafil offers significant cost savings compared to brand-name Viagra, typically under $3 per dose versus $70+ for brand-name, while providing equivalent effectiveness.

All three are PDE5 inhibitors with the same basic mechanism. The differences are duration and onset. Sildenafil takes 30 to 60 minutes to take effect and lasts 4 to 6 hours; it is best for planned encounters. Tadalafil takes 30 to 60 minutes to take effect but lasts 24 to 36 hours, making it better for spontaneity or daily use. Vardenafil takes effect in 25 to 60 minutes and lasts 4 to 6 hours; it is sometimes better tolerated by men who experience side effects from sildenafil. We can help determine which fits your needs.