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Viagra is an oral drug for male impotence, also known as erectile dysfunction (ED). It works by dilating blood vessels in the penis, allowing the inflow of blood needed for an erection.

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Most important fact about Viagra

Viagra causes erections only during sexual excitement. It does not work in the absence of arousal.

How should you take Viagra ?

Taking Viagra approximately 1 hour before sexual activity works best for most men. Depending on how and when the drug works for you, an interval of one-half hour to as much as 4 hours may prove ideal.

If you miss a dose of Viagra

Viagra is not for regular use. Take it only before sexual activity.

Storage instructions for Viagra

Store at room temperature.

What side effects may occur when taking Viagra?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Viagra.

More common side effects of Viagra may include:

Abnormal vision (color tinge, blurring, sensitivity to light), acid indigestion, diarrhea, flushing, headache, nasal congestion, urinary tract infection
Heart attack, stroke, heart irregularities, dangerous surges in blood pressure, and sudden death have all been reported after use of Viagra, usually in men with existing cardiac risk factors, and typically during or shortly after sex.

Why should Viagra not be prescribed?

Do not take Viagra if you are taking any nitrate-based drug, including nitroglycerin patches (Nitro-Dur, Transderm-Nitro), nitroglycerin ointment (Nitro-Bid, Nitrol), nitroglycerin pills (Nitro-Bid, Nitrostat), and isosorbide pills (Dilatrate-SR, Isordil, Sorbitrate). Combining Viagra with these drugs can cause a severe drop in blood pressure.

If Viagra gives you an allergic reaction, do not use it again.

Special warnings about Viagra

If you have heart problems severe enough to make sexual activity a danger, you should avoid using Viagra. Use it cautiously--if at all--if you've had a heart attack, stroke, or life-threatening heart irregularities within the past 6 months. Be equally cautious if you have severe high or low blood pressure, heart failure, or unstable angina (crushing heart pain that occurs at any time).

If you take Viagra and develop cardiac symptoms (for example, dizziness, nausea, and chest pain) during sexual activity, do not continue. Alert your doctor to the problem as soon as possible.

If you have a condition that might result in long-lasting erections, such as sickle cell anemia, multiple myeloma (a disease of the bone marrow), or leukemia, use Viagra with caution. Also use cautiously if you have a genital problem or deformity such as Peyronie's disease. If an erection lasts more than 4 hours, seek treatment immediately. Permanent damage and impotence could result.

If you have a bleeding disorder, a stomach ulcer, or the inherited eye condition known as retinitis pigmentosa, use this medication with caution. Its safety under these circumstances has not yet been studied.

To avoid low blood pressure, do not take the 50-milligram or 100-milligram dose of Viagra within 4 hours of taking an alpha-blocking drug such as Cardura.

Remember that Viagra offers no protection from transmission of sexually transmitted diseases, such as HIV, the virus that causes AIDS.

Possible food and drug interactions when taking Viagra

If Viagra is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Viagra with the following:

Other impotence remedies including Caverject and Muse
Alpha-blockers such as doxazosin (Cardura)
Amlodipine (Norvasc)
Cimetidine (Tagamet)
Erythromycin (E-Mycin, Ery-Tab, PCE)
Itraconazole (Sporanox)
Ketoconazole (Nizoral)
Nitrates such as Isordil, Nitro-Bid, and Nitro-Dur
Rifampin (Rifadin, Rimactane)
Ritonavir (Norvir)
Saquinavir (Fortovase, Invirase)

Special information on Viagra if you are pregnant or breastfeeding

Viagra should not be used by women. Its affects during pregnancy and breastfeeding have not been studied.

Recommended dosage of Viagra

Doses range from 25 milligrams to 100 milligrams, depending on the drug's effect. The usual dose is 50 milligrams. If you are over 65, have liver or kidney problems, or are taking erythromycin, ketoconazole, itraconazole, ritonavir, or saquinavir a dose of 25 milligrams may be sufficient. Your doctor will adjust the dosage if the drug is not working properly for you.

Take Viagra only before sexual activity. The manufacturer recommends a maximum of 1 dose per day (1 dose every 2 days for those taking ritonavir).

To avoid low blood pressure, do not take the 50-milligram or 100-milligram dose of Viagra within 4 hours of taking an alpha-blocking drug such as Cardura.

Overdosage when taking Viagra

No overdose of Viagra has been reported. However, any medication taken in excess can have serious consequences. If you suspect an overdose with Viagra, seek medical attention immediately.

Other uses of Viagra

Pulmonary hypertension

As well as erectile dysfunction, Viagra is also effective in the rare disease pulmonary arterial hypertension (PAH). It relaxes the arterial wall, leading to decreased pulmonary arterial resistance and pressure. This in turn reduces the workload of the right ventricle of the heart and improves symptoms of right-sided heart failure. Because PDE-5 is primarily distributed within the arterial wall smooth muscle of the lungs and penis, sildenafil acts selectively in both these areas without inducing vasodilation in other areas of the body. Pfizer submitted an additional registration for Viagra to the FDA, and Viagra was approved for this indication in June 2005. The preparation is named Revatio, to avoid confusion with Viagra, and the 20 milligram tablets are white and round. Viagra joins bosentan and prostacyclin-based therapies for this condition.

Raynaud's phenomenon

In 2005, Dr. Roland Fries and colleagues reported that Viagra cut the frequency of Raynaud's phenomenon attacks, reduced their duration by roughly one half, and more than quadrupled the mean capillary blood velocity. This was a double-blind, placebo-controlled crossover trial and the patients had both the primary and secondary forms and had all discontinued the more conventional treatments for this.

Viagra and altitude sickness

Viagra has been shown to be useful for the prevention and treatment of High altitude pulmonary edema associated with altitude sickness such as that suffered by mountain climbers. While this effect has only recently been discovered, Viagra is already becoming an accepted treatment for this condition, particularly in situations where the standard treatment of rapid descent has been delayed for some reason.

Duchenne/Becker Muscular Dystrophy

Viagra has recently been used to enhance cGMP signaling, specifically downstream and independent of NO formation, in dystrophin-deficient mouse hearts. Chronic treatment improved contractile performance, myocardial metabolic status, and sarcolemmal integrity, highlighting its potential clinical avenue for the treatment of the dystrophin-related cardiomyopathies.

Viagra and the use in sports

Professional sports players have been using drugs such as Viagra thinking that the opening of their blood vessels will enrich their muscles, therefore enhancing their performance.

Non-medical use of Viagra

Aphrodisiac

Viagra is commonly and increasingly used as an aphrodisiac, i.e. to increase sexual desire. However, there is no clinical evidence that Viagra has aphrodisiac activity, because it does not have any direct effect on the brain, although increased ability to attain an erection may be interpreted as increased sexual arousal by users of these drugs.

Recreational use of Viagra

Viagra's popularity with young adults has increased over the years. It is sometimes used recreationally. Some users mix Viagra with methylenedioxymethamphetamine (MDMA, ecstasy) in an attempt to compensate for the side effect common to many amphetamines of erectile dysfunction, a combination known as "sextasy", "rockin' and rollin'", or 'trail mix'."

Prevention of plant wilting

A low-concentration solution of Viagra in water significantly prolongs the time before cut flowers wilt; one experiment showed a doubling in time from one week to two weeks. The mechanism of action is similar to that in humans: nitric oxide leads to the production of cGMP whose degradation by PDE5 is inhibited by Viagra.

Jet lag research

The 2007 Ig Nobel Prize in Aviation went to Patricia V. Agostino, Santiago A. Plano and Diego A. Golombek of Universidad Nacional de Quilmes, Argentina, for their discovery that Viagra aids jet lag recovery in hamsters.Their research was published in the Proceedings of the National Academy of Sciences.

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