What are the effects of Sildenafil (Viagra)?

From the Guidelines

Viagra (sildenafil) is a prescription medication that can effectively treat erectile dysfunction, but it should only be used under the guidance of a healthcare provider due to potential risks and side effects, as highlighted in studies such as 1 and 1. The effects of sildenafil (Viagra) include statistically significant and clinically relevant improvements in sexual intercourse and erectile function in patients with erectile dysfunction (ED) 1. However, higher doses of sildenafil are associated with a greater risk for adverse effects, and nitrate therapy is a contraindication for treatment with oral PDE-5 inhibitors like sildenafil 1. Some key points to consider when evaluating the effects of sildenafil include:

• The American College of Physicians recommends initiating therapy with a PDE-5 inhibitor in men who seek treatment for ED and do not have a contraindication to PDE-5 inhibitor use, as stated in 1.
• The choice of a specific PDE-5 inhibitor should be based on individual preferences, including ease of use, cost of medication, and adverse effects profile, as recommended in 1 and 1.
• Higher doses of sildenafil and vardenafil are associated with a modestly greater magnitude of benefit with respect to erectile function, but also with a greater risk for adverse effects, as noted in 1.
• PDE-5 inhibitors are relatively well tolerated and are associated with mild or moderate adverse events, but evidence is insufficient to determine whether they are associated with an increased risk for certain serious adverse events, such as NAION, as discussed in 1. In summary, while sildenafil can be an effective treatment for ED, its use should be carefully considered and monitored by a healthcare provider to minimize potential risks and side effects, as emphasized in studies such as 1, 1, and 1.

From the FDA Drug Label

The following serious adverse events are discussed elsewhere in the labeling: Mortality with pediatric use, Hypotension, Vision loss, Hearing loss, Priapism, Vaso-occlusive crisis The most common side effects with sildenafil tablets include: Nosebleed, headache, upset stomach, getting red or hot in the face (flushing), trouble sleeping, as well as fever, erection increased, respiratory infection, nausea, vomiting, bronchitis, pharyngitis, runny nose, and pneumonia in children. low blood pressure. Low blood pressure may cause you to feel faint or dizzy. more shortness of breath than usual. decreased eyesight or loss of sight in one or both eyes (NAION). sudden decrease or loss of hearing. heart attack, stroke, irregular heartbeats, and death. erections that last several hours.

The effects of Sildenafil (Viagra) include:

• Common side effects:
  • Nosebleed
  • Headache
  • Upset stomach
  • Flushing
  • Trouble sleeping
• Serious side effects:
  • Low blood pressure
  • Shortness of breath
  • Decreased eyesight or loss of sight
  • Sudden decrease or loss of hearing
  • Heart attack, stroke, irregular heartbeats, and death
  • Erections that last several hours 2, 2, 2

From the Research

Effects of Sildenafil (Viagra)

The effects of Sildenafil (Viagra) can be understood in terms of its efficacy, safety, and potential interactions with other medications.

• Efficacy: Sildenafil has been shown to be effective in treating erectile dysfunction (ED) in men of various ages and with different etiologies 3, 4, 5.
• Safety: The most common adverse effects associated with sildenafil usage are headache, flushes, dyspepsia, visual disturbances, and nasal congestion/rhinitis, which are usually transient and mild 3, 4.
• Interactions: Sildenafil is contraindicated in patients taking organic nitrates, and caution is necessary in patients with cardiovascular disease, uncontrolled hypertension, and impaired cardiac reserve 4, 6, 7.

Cardiovascular Risks

The use of sildenafil may pose cardiovascular risks, particularly in patients with pre-existing heart conditions.

• Sildenafil can cause a mild decrease in systemic arterial pressure, and its use is contraindicated in patients taking organic nitrates due to the risk of severe hypotension 6, 7.
• Patients with coronary artery disease, hypertension, or cardiac insufficiency should be evaluated by a cardiovascular specialist before using sildenafil 7.
• Regular exercise may help prevent triggering of myocardial infarction during sexual activity 7.

Comparison with Other Treatments

Sildenafil has been compared to other phosphodiesterase inhibitors, such as vardenafil and tadalafil, in terms of efficacy and safety.

• Vardenafil is more potent and selective than sildenafil, but has a similar efficacy and safety profile 5.
• Tadalafil has a longer duration of action than sildenafil and vardenafil, and may be preferred by men with ED due to its longer duration of action 5.