Viagra professional: Top five myths about this popular drug

How Sildenafil Compares To Other ED Drugs

Sildenafil, sold under the trade names Viagra and Revato, is a drug used primarily for the treatment of erectile dysfunction. It is the prototypical phosphodiesterase type V inhibitor, which has been of a significant help in saving the sex-life  of many that have suffered erectile dysfunction.

Pharmacokinetics of Sildenafil

Pharmacokinetics refers to what the body does to a drug. Sildenafil is administered both orally and parenterally as an intravenous bolus. It has a bioavailability of about 40%, and its plasma protein binding is about 96%. Its onset of action is within 20 to 30 minutes, and its pharmacological effects last for about 2 hours. It is metabolized by the the liver microsomal enzyme system majorly CYP3A4, and to some extent CYP2C9. Its metabolite N-desmethylsildenafil has an approximate potency of 50% for PDE5 receptors (phosphodiesterase type 5 receptors). The elimination half life for sildenafil is about 3 to 4 hours, and it is excreted largely in feces and a small portion is excreted in urine.

The oral dosage form is sildenafil tablets available as viagra or revatio (both having different indicatons), whereas the intravenous formulation is a sildenafil salt, sildenafil citrate. 

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Mechanism of Action

Generic Sildenafil is a selective inhibitor of PDE5 in the helicine vessels of the corpus cavernosum, which plays a key role in degradation of cyclic guanosine monophosphate(cGMP). During normal erectile process, nitric oxide in the corpus cavernosum binds to the guanylate cyclase receptors , which results in increased levels of intracellular cGMP, leading to smooth muscle relaxation of the intimal cushions of the helicine arteries, and this leads to vasodilation and increased blood flow into the erectile tissue of the penis, causing an erection. Sildenafil is therefore a potent and selective inhibitor of PDE5. Its molecular structure is similar to that of cGMP, and is a competitive substrate for PDE5, and this prevents binding of cGMP, leading to conservation of cGMP, hence maintaining erections in people with sexual dysfunction/erectile dysfunction/impotence.

Dosage and Indications

Treatment of erectile dysfunction- only Viagra professional is recommended for this. The recommended dose is 50 mg PO, 30 to 40 minutes before sexual activity. The maximum frequency dosing is once in a day. Based on effectiveness and tolerance, may increase dosage to 100 mg or decrease to 25 mg. Treatment of Pulmonary Arterial Hypertension- only Revatio is recommended for this. The recommended dosing is 5mg to 20mg  PO TID, administered 4 to 6 hours apart. IV 2.5 mg or 10 mg bolus TID can be considered if the patient is temporarily unable to take it PO. Dose adjustment should be considered in renal insufficiency/impairment; the dose should be reduced because there would be an otherwise increase in plasma concentration of the drug, which could potentiate its adverse effects.

Adverse Effects: Sildenafil

The most common adverse effects are headache, flushing, indigestion, nasal congestion and impaired vision including photophobia and blurred vision (non-arteritic anterior ischemic optic neuropathy). In some patients, epistaxis, insomnia, erythema, diarrhea, dizziness and skin rash may be manifest.

Warnings/Contraindications and Drug-Drug Interactions

It should NOT be used in patients with a know hypersensitivity to sildenafil. Concomitant use with soluble guanylate cyclase stimulators such as riociguat should be avoided because it can cause hypotension. Concomitant administration with nitrates and NO donors such as sodium nitroprusside, isosorbide mononitrate and nitroglycerin should be avoided, as this may potentiate the hypotensive effects. It should be used with caution in patients with anatomic deformation of the penis (angulation, carvenosal fibrosis or Peyronie disease), conditions potentially predisposing to priapism( sickle cell anemia, multiple myeloma or leukemia), cardiovascular disease, bleeding disorders, active peptic ulcer disease, liver and renal disease, multidrug antihypertensive regimens and retinitis pigmentosa.

Sildenafil should not be taken with other PDE5 inhibitors

Patients should stop sildenafil and seek medical care if a sudden loss of vision occurs in one or both eyes, which could be a sign of non-arteritic anterior iscemic optic neuropathy. Underlying causes of ED should be evaluated before therapy is started to avoid unnecessary sildenafil use because of the underlying cardiovascular risks. Concomitant use with CYP3A4 inhibitors (antiretroviral protease inhibitors,erythromycin and cimetidine) can markedly increase plasma concentrations of sildenafil, potentiating its adverse effects. This is because the aforementioned drugs inhibit metabolism of sildenafil, raising its plasma concentrations. It is not advisable for use in children under the age of 18.

Dr. John Hanson, MD

Trauma surgeon at Sydney Medical Centre
Dr. John Hanson, MD Dr. John Hanson, MD has been a resident of the Sydney area since the 1980's when he immigrated with his parents from South Africa after they were caught between the violence of two warlords. Dr. Hanson attended Sidney High School where he graduated at the top of his class. He went on to attend ANU Medical School where he studied for several years. Dr. Hanson graduated from ANU Medical School with a 4.0-grade point average and became an intern at Sydney Children's Hospital. Dr. Hanson was always trying to spend time outdoors where he would collect small animals and large insects to study. He would frequently come home with a tarantula in a box or a pet snake. One time Dr. Hanson discovered a baby Koala who was all alone after its parents were killed in a wildfire. Dr. Hanson nursed the baby Koala back to health and he continued to raise it since it had no hope of being reintroduced to the wild. Dr. Hanson became known for his pet Koala and he would even bring the Koala which he named Reginald to the hospital to visit sick children. Dr. Hanson quickly became a legendary name at the children's hospital where he worked as an intern thanks to his buddy Reginald. Upon concluding his internship, Dr. Hanson went on to become a resident Doctor at Sydney Medical Centre where he treated burn victims, car accident victims, and other traumatic injuries. The ability to operate with a steady hand and remain focused despite the grievous injuries in front of him earned him a reputation for being the best at the hospital. Sydney Children's Hospital offered Dr. Hanson a position on the board in 2014 and in 2017 Dr. Hanson became the President of the Sydney Children's Hospital but still maintained his role at Sydney Medical Centre as a trauma surgeon. The ability to work calmly under pressure is the trait of a good doctor and Dr. Hanson is no exception. He has a cunning business sense and a heart filled with passion for helping others and is known as an asset to the community of Sydney.
Dr. John Hanson, MD

19 thoughts on “Viagra professional: Top five myths about this popular drug

  1. The shock of my wife divorcing hurt me deeply, We had been married 20 years and had a very healthy sex life.
    Years later I finally found the right woman ,she was smart,loyal and beautiful. Even so when it came time to
    Perform not only did I find it all new to me but added to that shyness was the fear of losing another love.
    I talked to my Dr. and he prescribed Viagra professional 100 mg doses ‘just to get you over the hump”he said.
    You will be fine once you get rolling again. He was right my new love and I have been married three years now.
    We could not be happier or more satisfied.Thanks doc!

  2. I am 57 and usually took 75mg of Viagra. It was life changing. But I switched to Viagra Professional because the time to take the desired effect is greatly reduced and the erection seems better and last longer. It iis like I am 18 again driving a new sports car.

  3. As a 52 year old man with ED, I’ve tried quite a few drugs to fix it, but none of them have worked. I tried Viagra professional 50mg by recommendation of my doctor. Now I no longer have any issues!

  4. Im 30 years old and I do not have a need for Viagra. I will however say that I have used it on occasion as a recreational drug and found the benefits to be great. It is comforting to know that if and when I do have a need for this drug that it exists.

  5. My partner has used Viagra professional for as long as I have been with him and it has never failed us and gives him confidence in sex that he didn’t have before.

  6. Viagra professional goes beyond that of the original medication, activating in only 15-20 minutes and lasting for at least 8 hours. It revolutionizes ED treatment in the 21st century.

  7. When I was about I had suffer ED in my sex life . I state told my family doctor .He initial prescriber me 25mg . 30 minutes before intercourse .
    It work for a while but it stop. I went back to my doctor it increase to 100mg super active . It work good and felt like my youth. Even My mistress
    say I become a tiger.

  8. Viagra has helped me rediscover my youth! I had lost so much confidence over the past couple years due to my inability to get and stay hard. Now that problem is gone! With no side effects!

  9. As someone who was satisfied with the effect of regular Viagra, knowing that Viagra professional has double the drug, I think it is unnecessarily powerful for me personally.

  10. I took 50 mg, and it completely changed my sex life! I was able to hold an erection and find the perfect dose the first time. It was incredible and I will be sure to get it again.

  11. My sex life has been more and more disappointing over the years. I still got sexually aroused, but it wasn’t until I started taking 25mg of Viagra that I could get a long-lasting and firm erection. It has made all the difference in the world and I don’t know why I didn’t try it sooner.

  12. Viagra is the trade name for a drug called Sildenafil. Viagra is one of a class of drugs known as PDE-5 (Phosphodiesterase type 5) inhibitors. Viagra and the other PDE-5 inhibitors can help men with erectile dysfunction (male impotence) by enhancing the erectile response when a man is sexually stimulated.Taking Viagra relaxes the walls of your blood vessels and lets blood flow more easily into the parts of your penis that cause an erection.The usual first-time dose of Sildenafil (Viagra) is one 50mg tablet, which is taken with a glass of water an hour before the time you’re planning to have sex. Viagra is also available in doses of 25mg and 100mg, so your prescriber will be able to advise whether a lower or higher dose might suit you better.

  13. Viagra is something that I often hear about older people using, or it being abused by younger folks who don’t need it in order to maintain erections that last for an insane amount of time.

  14. Hello, I am 34 year old dude, I have used Kamagra Jelly; I can testify that it works. I had lost my grip, after subscribing to the 50mg dose, I have never looked back. I now outperform my initial performances before I lost it, I will never stop using this product. Thank you guys.

  15. Trying Kamagra jelly brought back my sexual potency and pushed that erectile dysfunction out of my life. I was ready and able to have sex again, and not just sex, but great sex. It’s awesome to feel like a man again!

  16. I used some Kamagra jelly, I had tried Viagra in the past. I tell you Kamagra jelly was some of the best stuff I have ever had in my life. I got a super huge erection and it made me very happy. I like using the Kamagra jelly so much that I bought a bunch of it. It really helps me achieve the desired errection and my wife likes it too.

  17. I’ve been suffering from ED for a couple of years and have been very frustrated about it. I want to satisfy my wife, but nothing was working. Then I found Kamara jelly. What a wonder! I tried 50mg last night and WOW! It was so effective! Will definitely continue its use to see if it continues to work as well, but the reviews are great!

  18. Kamagra jelly is something i thought sounded silly and almost a joke. I did not take it seriously at first. But given the embarrassment i was feeling about myself and worried as to how it was affecting my love life with my wife. I gave it a shot. It toook me by surprise as to how it actually worked.

  19. Kamagra is not a simple medicine that will bring your old friend up when your old, but bringed me back that guy of past ages that acted as a real person all over again, lifting up my self esteem and erasing my depression.

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