What is Sildenafil? 

Sildenafil is a medication specifically designed to help men experiencing erectile dysfunction. It belongs to a class of medicine called PDE5 inhibitors, which improve blood flow to certain parts of the body. Sildenafil works by relaxing the muscles in blood vessels, allowing for better circulation. Originally developed for heart-related conditions, it was later found to be highly effective for treating ED. 

The medication is available under various brand names, including Viagra and Revatio, and is widely prescribed for its effectiveness and safety. Sildenafil is taken as needed, usually one hour before sexual activity, and has transformed the lives of millions of men worldwide. 

What is Sildenafil Used For? 

Erectile Dysfunction: Sildenafil helps men achieve and maintain an erection for satisfying sexual activity. 
Pulmonary Arterial Hypertension: It reduces high blood pressure in the arteries of the lungs. 
Raynaud’s Phenomenon: Sildenafil may be used to treat this condition affecting blood flow to the fingers and toes. 
 
At 123Meds, we offer Sildenafil for the treatment of Erectile Dysfunction only - if you are interested in using Sildenafil for any other condition, we would advise that you seek further review from your GP to determine whether it is an appropriate treatment option.

How Sildenafil Works 

Sildenafil enhances blood flow to the penis by relaxing the blood vessel walls, making it easier for men to achieve an erection when sexually aroused. 

Mechanism of Action: 

Increases Nitric Oxide: Sildenafil promotes nitric oxide release, which relaxes blood vessels. 
Blocks PDE5 Enzyme: It inhibits PDE5, preventing the breakdown of cGMP, a molecule that aids erections. 
Improves Blood Flow: The relaxed vessels allow more blood to flow to the penis, enabling a firm erection. 

When is Erectile Dysfunction Confirmed, and Medication Needed? 

Erectile dysfunction (ED) is confirmed when a man consistently has trouble achieving or maintaining an erection that is firm enough for sexual intercourse.

Unlike occasional performance issues, which are common amongst most men, ED is a recurring problem that significantly impacts a person’s sexual and emotional well-being. ED can have various causes, including both physical and psychological factors. Physical causes are typically linked to issues with blood flow, nerve function, and hormones, while psychological causes are more related to stress, anxiety, and emotional challenges. 

Physical causes of ED: 

Poor blood flow due to conditions like high blood pressure, heart disease, diabetes, or high cholesterol can prevent sufficient blood from reaching the penis. 
Nerve damage from injury or surgery can disrupt the signals required for an erection. 
Hormonal imbalances, such as low testosterone, can interfere with sexual function. 

Psychological causes of ED: 

Stress, anxiety, and depression can affect mental health and reduce sexual arousal. 
Relationship problems can lead to emotional barriers that impact performance. 

Symptoms of ED: 

A reduced desire for sex 
Weak erections or the inability to sustain an erection 
Difficulty getting an erection 
If these symptoms last for weeks or more, it is crucial to seek medical help. 

Doctors will diagnose it based on your sexual or medical history. Based on the underlying causes, treatment options may include medications like Sildenafil to improve blood flow to the penis. Depending on the individual’s needs, other medications or therapies may also be recommended. It’s important to consult with a healthcare provider to find the most suitable treatment plan. 

Can Sildenafil Be Purchased Over the Counter? 

Sildenafil is available over the counter in some countries, including the UK. In the UK, it can be purchased at pharmacies without a prescription, but only in lower doses up to  50 mg.

Higher doses of 100 mg are available on prescription only. However, a consultation with a prescriber is required to ensure that the medication is safe and appropriate. Your 123meds prescriber will determine if it is suitable for you, depending on your medical history. 

Alternative Medications 

While Sildenafil is a common treatment for erectile dysfunction, other medications can also help depending on the individual's needs. Here are some alternatives that we offer at 123Meds: 

Tadalafil (Cialis): This medication works similarly to Sildenafil but has a longer-lasting effect, up to 36 hours, which means it is often called the "weekend pill." This longer acting quality of Tadalafil makes it ideal for those patients who want to be able to have spontaneous and more frequent sexual activity.
Vardenafil (Levitra): Vardenafil is another PDE5 inhibitor, similar to Sildenafil, that treats ED. It works in a similar way to Sildenafil, but it tends to have fewer side effects, such as less risk of dizziness or facial flushing. It can last for around 4–5 hours and can be taken as needed. 
Avanafil (Stendra): Avanafil is a newer medication for ED. It works faster than Sildenafil and other ED medications, typically within 15–30 minutes of taking it. This fast onset makes it ideal for men who may not have planned ahead for sexual activity. 

Speak to your 123Meds prescriber if you are unsure about the best treatment for you. 

Timing: Sildenafil should be taken 30–60 minutes before engaging in sexual activity.

Dosage: The usual starting dose of Sildenafil is 50 mg. The dose may be changed based on your response to the medicine or if you have any coexisting medical conditions such as high blood pressure. We can look to adjust your dosage to 25 mg or increase it to 100 mg based on how well the medicine works and your tolerance. Importantly, Sildenafil should not be taken more than once a day as more frequent dosing is unlikely to produce additional benefits and increase the risk of side effects. Always follow your 123Meds prescriber guidance and directions when taking your medication. 

With Food: While Sildenafil can be taken with or without food, consuming a high-fat meal beforehand can slow down its absorption. This may delay the onset of its effects, so lighter meals or snacks are preferred to ensure quicker and more reliable results. 

Avoid Alcohol: Alcohol consumption while taking Sildenafil can diminish its effectiveness and lead to undesirable side effects like dizziness, headaches, or fainting. To maximize the benefits of the medication, it’s best to avoid alcohol or limit its intake significantly. 

If you missed a dose of Sildenafil, there’s no need to worry since it’s taken only as needed before sexual activity. But, do not take more than one dosage in a 24-hour period.

Sildenafil contains both active and inactive ingredients that work together to provide the desired effects. 

Active Ingredient:
The active ingredient in Sildenafil is Sildenafil Citrate, which improves erectile function by increasing blood flow to the penis, helping men achieve and maintain an erection suitable for sexual activity. 

Inactive Ingredients:
Inactive ingredients like lactose, microcrystalline cellulose, croscarmellose sodium, and magnesium stearate help shape the tablet, ensure stability, and aid in absorption.

Always check the patient information leaflet (PIL) in your pack for the full ingredient list — especially if you have skin allergies or sensitivities.

Sildenafil is generally safe for most men, but like all medications, it can cause side effects. Most side effects are mild and temporary. However, some more serious side effects require immediate medical attention. 

Common Side Effects: 

Headache: A frequent side effect of Sildenafil. 
Flushing: A reddening of the face, neck, or chest. 
Nasal Congestion: A stuffy or runny nose can occur. 
Stomach Upset: Some men experience indigestion or nausea. 
Vision Changes: Blurry vision or a blue tint can occur temporarily. 
Dizziness: Some men may feel lightheaded or dizzy. 
MusclePain: Aching or sore muscles can happen after taking the drug. 
Skin Rash: Red, itchy skin can appear in rare cases. 

Less Common but Serious Side Effects: 

Priapism: A prolonged, painful erection that lasts more than 4 hours and requires immediate medical help. 
Vision Loss: Sudden loss of vision in one or both eyes is very rare but requires urgent medical attention. 
Hearing Issues: Sudden hearing loss or ringing in the ears may occur in rare cases.  
 

If you experience severe or persistent side effects such as priapism, sudden vision loss, or hearing issues, you should report yourself to the A&E( Accident and Emergency) Department. Don’t ignore unusual or alarming symptoms, as these are medical emergencies, and prompt care can prevent complications. 

Before starting Sildenafil, please ensure that you have declared all pre-existing conditions to us so that your prescriber can determine the most appropriate treatment and dosage.