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Sildenafil

Sildenafil: An Introduction 

Your decision to take control of your sex life with Sildenafil, a generic though equally effective version of Viagra, is a crucial first step. However, there are a number of important factors to keep in mind as you begin your journey. Understanding all of the information included here not only provides valuable insight into your health and safety, but also ensures you get the best results from the medication.

Sildenafil 101

Sildenafil should be taken an hour before sexual intercourse but the effect may kick in sooner. This will help achieve maximum results by increasing your enjoyment and staying power. On average, you’ll have a three- to four-window after taking your prescribed dosage for it to work. 

Victory Select provides a generic version of Sildenafil in a rapidly dissolving troche (a wax medicinal lozenge). While Viagra is available in 25mg, 50mg, or 100mg doses, the 50mg dose is the most commonly effective dose. We offer Sildenafil in 60mg doses to increase its effectiveness.

Unfortunately, many sites offer smaller doses to attract patients with lower prices. However, the cost actually increases because patients have to take more for the medication to work. At Victory Select, however, we offer a full dose. It’s the most medicinally effective treatment plan that we have experienced. Although 60mg is the recommended dose, you are welcome to split the troche in half if you find it still works. Simply use your fingernail or pill cutter to break it in half.

Remember: you’ll only get an erection when you’re aroused, and how easily you’re aroused will depend on a variety of internal and external factors, including lifestyle and age. Additional information on the importance of exercise, diet, and other tips is provided later in this document. (See “Sildenafil and Staying Healthy.”) Again, understanding every aspect of Sildenafil and your treatment plan is the only way to know if this medication is right for you. Being an honest and observant student of your body and its reaction to Sildenafil, and communicating as openly and frequently as necessary with your doctor, will maximize your chances for success. These practices will also keep you healthy and safe.

Any changes to medicines you’ve already been prescribed, or any new medications you’re taking after you’ve begun your course of treatment with Sildenafil, require immediate notification of your doctor. If you have underlying conditions such as heart or vascular disease, Sildenafil may have serious negative side effects. This information, as well as any side effects, should be immediately communicated to your doctor. (See “Warnings About Sildenafil” for more info.) 

If you have any questions or concerns, please don’t hesitate to contact us.

How Sildenafil Works

Sildenafil (Viagra) is a reversible, selective phosphodiesterase type 5 (PDE5) inhibitor. Phosphodiesterase inhibitors come in different types and were originally used to treat high blood pressure. There are similarities between these types, but there are crucial differences as well. Most of these differences center on the time the medication takes to work and leave the body, as well as the duration of action. Sildenafil can begin working in less than one hour, leaves the body in four to eight hours, and depending on the dose, is effective between four to six hours. Men seeking longer staying power may prefer Tadalafil (Cialis).

Warnings About Sildenafil

Keeping the lines of communication open with your doctor is an integral part of your treatment plan, especially when it comes to using other medications. Even over-the-counter medications have the potential to negatively interact with Sildenafil. You can never be too careful when it comes to combining drugs, so please be sure to notify your doctor of any and all changes. For a detailed though by no means comprehensive list of potentially harm drug interactions, see our list under “A Guide to Sildenafil and Other Medications.” Here are some potentially adverse reactions to Sildenafil and what to do if you experience them.

If You Experience Any of the Following, Seek Immediate Emergency Medical Attention…

There are a variety of serious medical issues that can result from using PDE5 inhibitors. For example, because PDE5 inhibitors were originally developed to treat high blood pressure, some patients’ blood pressure drops to extremely low levels. Those patients taking medications for angina such as nitrites and nitrates are advised not to take Sildenafil and must divulge this information to their doctor. Poppers, a propellant used in commercial whip cream, are frequently used as a recreational drug but contains nitrates and is very dangerous when mixed with erectile drugs.

Another potential serious side effect to keep in mind as you begin treatment: issues related to eyesight. In rare cases, patients can suffer permanent blindness in one or both eyes. If this happens to you, seek immediate emergency medical attention.

Finally, it’s possible using Sildenafil results in Priapism, or an erection lasting beyond four hours. This is a potentially serious issue, as it can not only result in physical pain, but also damage tissues and blood vessels. 

These are examples of serious side effects that require immediate emergency medical attention. If you have any doubts about the level of severity of a potential side effect you’re feeling, such as shortness of breath, visual changes, or fainting, contact us immediately.

Not all side effects associated with PDE5 inhibitors require immediate emergency medical attention. These side effects, while relatively uncommon, can cause the type of discomfort typically associated with your average cold. Dizziness, stuffiness, headaches, and upset stomach have been reported in some patients. 

In addition, it’s also possible that your vision could be temporarily tinted blue. This symptom is unique to Sildenafil (Viagra). If you experience this or any other side effects, or if you have any questions about discomfort that may be associated with Sildenafil, contact us immediately. 

If You Suffer from Any of the Following Conditions or Ailments, Exercise Caution…

The Physician Desk Reference, or PDR, is a good resource regarding prescription medication. It advises patients who’ve been prescribed Sildenafil to exercise caution if they suffer from, or have endured, one or more of the following:

  • Myocardial infract, stroke, or arrhythmias in the last six months
  • Resting hypotension and/or resting hypertension
  • Fluid depletion
  • Cardiac disease
  • Heart failure
  • Coronary artery disease
  • Active coronary ischemia (blocked heart arteries)
  • Low blood pressure and/or low blood volume
  • High blood pressure and on a “complicated, multi-drug, anti-hypertensive program”
  • Aortic stenosis
  • Idiopathic hypertrophic subaortic stenosis
  • GERD or hiatal hernia
  • Angulation
  • Cavernosal fibrosis
  • Peyronie’s disease

Sildenafil Dos and Don’ts 

To maximize the effects of Sildenafil and to minimize the potential for adverse reactions, please keep in mind the following dos and don’ts.

The Dos

  • Are you on an alpha-blocker (e.g. Prazosin)? Then do make sure you’re 1) on the lowest dose possible 2) prescribed a constant dose prior to taking Sildenafil and 3) not taking Sildenafil within four hours of taking an alpha blocker.
  • Do follow up with us. We want to make sure you’re maintaining both your sexual health and your health overall, especially your cardiovascular function. Again, it’s important to notify a medical professional if you there are any changes to your other prescriptions or if you’re prescribed a new drug, as well as if you have any side effects (see “Warnings About Sildenafil”).  We are available via email or phone.
  • When you’re initially prescribed Sildenafil, do test it out by yourself. This will help you determine 1) what if any side effects you experience and how best to treat them 2) figure out the timing, including when Sildenafil begins to work and the duration of action and 3) reduce your overall performance anxiety prior to engaging in sexual activity with a partner. 

The Don’ts

  • Concerned about when or whether to eat and drink in conjunction with Sildenafil? Don’t be. Because Sildenafil is delivered in a troche form (see “Sildenafil 101” for details), it will not be affected by the consumption of food and non-alcoholic beverages.  Be aware that consuming alcohol while taking Sildenafil can negatively impact your ability to achieve an erection. (See “Sildenafil and Staying Healthy” for more.)

Common Misconceptions about ED

Sexual intercourse and related activities are both biologically and emotionally complex undertakings. These complexities are important to keep in mind as you begin your journey with Sildenafil.  

While Sildenafil helps you achieve an erection, there are ancillary concerns associated with sex generally and erectile disfunction specifically that are important to understand. Sex is a two-person act, and maintaining an erection throughout the sex act is not always possible for some men. Should you experience this issue, it may be necessary to talk through it with your partner in order to find a solution.

Another factor preventing an erection from lasting during intercourse is anxiety. This can happen for a number of reasons, including not having sex for a long period of time prior to beginning ED treatment. Indeed, for such men, their initial sexual experiences after beginning their course of treatment may result in premature ejaculation. On the other hand, some men find that PDE5 inhibitors delay orgasm or in some cases, inhibit it entirely. 

The good news: Victory Select offers treatments for these issues, as well as alternative treatments for ED. For more information on the latter, see the next section (“Victory Select’s ‘Male Daily’ and Other Alternative Treatments”).

Victory Select’s Alternative Treatments

Why would you need an alternative treatment?

Unfortunately, Sildenafil doesn’t work for about 15 percent of patients. Complications associated with diabetes, cardiovascular disease, and neurological diseases, among other conditions and ailments, could prevent Sildenafil from have its desired effect. In addition, invasive surgeries, radiation therapy, and other factors that could lead to nerve damage have a similarly negative impact on Sildenafil’s effectiveness. As always, it’s important to let your doctor know if you check any of these boxes. (See “Talking Sildenafil and More with Your Doctor.”)

As you begin your treatment, consider it part of a larger process whose ultimate goal is to provide you with overall better sexual experiences. This is why we emphasized in the introduction and elsewhere in this document the importance of being a good steward of your body by paying attention to Sildenafil’s effects. (See also “Sildenafil Do’s and Don’ts” and “Warnings About Sildenafil.”) 

What alternative treatments do Victory Select or other practitioners offer?

Now, the good news. At Victory Select, we offer an alternative supplement for patients. Below is a brief explanation.  Please bear in mind that this is an overview and not intended as a full explanation, nor is this list of alternatives comprehensive. Talk to your doctor if you’re interested in exploring these or other options.

Male Daily—Victory Select Only

Victory Select offers a proprietary testosterone boosting blend called Male Daily. This supplement is designed to increase testosterone levels, improving mood, libido, memory, muscle strength, erectile function, and more. While increased testosterone does facilitate better erectile function, particularly if taken for a period greater than six months, Male Daily can still be a valuable supplement for the other purposes listed above. And it can be taken in conjunction with prescription erectile dysfunction medications.  

Alprostadil—Not Offered by Victory Select (Check with Your Personal Provider or Victory Medical’s brink and mortar facility.)

This medication can be delivered either via a penile injection (a literal injection directly into the penis) or a penile suppository (a pellet inserted directly into the urethra). Regardless of the method, Alprostadil works the same way: it causes blood to flow to the penis in order to induce an erection. Both the suppository and injection methods carry a number of risks and potential drawbacks along with a guaranteed erection.

HRT—Not Offered by Victory Select (Check with Your Personal Provider or Victory Medical’s brick and mortar facility.)

Low testosterone in men can cause changes in sexual function, decreased energy, depression, erectile dysfunction, mood changes, loss of muscle mass, insomnia, increased body fat, decreased motivation, and increase in heart disease.  Talk to your doctor about HRT as an option to treat your erectile dysfunction.

Sildenafil and Staying Healthy

It should come as no surprise that your overall health and well-being matters when it comes to treating ED. (We’ve touched on this in multiple sections, including the introduction, “Warnings About Sildenafil,” and “Sildenafil Dos and Don’ts.”) Achieving an erection is a biologically complex process that requires the simultaneous interaction of hormones, blood distribution through arterial pathways, and signals sent from the nervous system. Any interruption to any of these processes can inhibit your ability to achieve an erection. 

That’s why your health and well-being are so crucial. When you’re sexually aroused, it’s because your mind and body are working together in an intricate dance where every move counts. So, to help improve your chance of success, we’ve compiled the following tips to maintaining a healthy lifestyle. 

Diet and Exercise 

What you do with your body and what you put into it matter for all sorts of reasons, including addressing ED. As you know, blood flow is an integral part of achieving an erection. That’s why your cardiovascular system needs to be firing on all cylinders, especially your heart. And one way to improve heart health is to exercise. Even a simple walk around the neighborhood can do wonders for your mental and physical well-being. Set an exercise schedule and stick to it.  

Diet also plays an integral role in combating ED. Even minimal reductions in body fat can help. That’s because obesity can reduce the blood flow to the penis, which inhibits achieving an erection. Besides causing and complicating ED, obesity is a primary risk factor for diabetes, high cholesterol, high blood pressure, and other diseases, afflictions, and ailments. Talk to your doctor about ways to improve your diet.

Sleep and Stress

Sleep and stress are related to each other, as well as to ED. If you aren’t getting enough sleep, you increase your risk for health problems, including decreasing your testosterone. As we noted in a previous section (“Victory Select’s Alternative Treatments”), testosterone levels and proper erectile function are inextricably linked. Reduced testosterone can also result in a diminished libido, limiting your sexual desire.

Limiting your stress is also important to a healthy sex life and to your health more generally. From reducing your blood pressure to obesity, keeping your stress in check keeps your mind and body working in harmony. This is essential to achieving and maintaining an erection. 

Managing your stress and getting enough sleep will help lead to a more satisfying and consistent sex life.

Booze and Beyond 

If you consume more than three alcoholic drinks per day, you’re far more likely to experience ED. That’s because alcohol is a depressant that inhibits mind-body communication. Excessive alcohol consumption prevents the blood vessels in the penis from functioning properly by inhibiting blood flow, which is essential to maintaining an erection. Reducing the amount you drink improves your health in numerous ways, from liver function to blood pressure to achieving an erection. 

Smoking can also lead to ED. If you smoke at least 10 cigarettes a day, your chances of suffering from ED increase two-fold. That’s because smoking damages your blood vessels. Quitting smoking improves your health overall in many ways, including increasing your circulation, a key factor in achieving and maintaining an erection. 

A Guide to Sildenafil and Other Medications

What follows is a detailed though by no means comprehensive list of potentially harmful medication interactions with Sildenafil. This list was developed using the PDR, which contains even more medications that may cause harm when taken with Sildenafil. If you have any questions or concerns about any medications you’re taking as you begin your treatment with Sildenafil, contact your doctor. 

    • Alfuzosin (Uroxatral) (Treats High Blood Pressure or Enlarged Prostate) 
    • Aliskiren (Tekturna, Rasilez) (Treats High Blood Pressure)
    • Alpha-blockers (e.g., Cardura, Coreg Flomax, Hytrin, Minipress, Oravase, Rapaflo, Regitine,Trandate) (Treats High Blood Pressure or Enlarged Prostate) 
    • Ambrisentan (Letairis) (Treats PAH–High Blood Pressure in the Arteries of the Lungs)
    • Amlodipine (Norvasc) (Treats High Blood Pressure)
    • Amprenavir (Agenerase) (Treats HIV)
  • Amyl Nitrite (Amyl nitrite Systemic, Poppers, Rush) (Recreational Drug)
    • Aprepitant (Emend) (Treats Nausea)
    • Atazanavir (Reyataz) (Treats HIV)
    • Atropine (Isopto Atropine) (Treats Eye Conditions)
    • Boceprevir (Pegasys, Pegintron) (Treats PAH and Hepatitis C)
  • Butyl Nitrate (Poppers, Rush, Liquid Gold) (It is a recreational drug) 
    • Brigatinib (Alunbrig) (Cancer)
    • Capecitabine (Xeloda) (Cancer)
    • Cariprazine (Vraylar) (Psychiatric Disorders)
    • Ceritinib (Zykadia) (Cancer)
    • Cimetidine (Tagamet) (Stomach Ulcers)
    • Ciprofloxacin (Proquin, Cipro) (Antibiotic) 
    • Clarithromycin (Biaxin) (Antibiotic)
    • Clopidogrel (Plavix) (Blood Thinner)
    • Cobicistat (Stribild, Tybost) (Treats HIV)
    • Conivaptan (Vaprisol) (Treats Low Sodium in the blood)
    • Crizotinib (Xalkori) (Cancer)
    • Darunavir (Prezista) (Treats HIV)
    • Dasabuvir (Viekira XR, Viekira Pak–contains Ritonavir*) (Treats Hepatitis C)
    • Delavirdine (Treats HIV)
    • Dihydroergotamine (Migranal) (Treats Migraines)
    • Diltiazem (e.g., Cartia, Cardizem, Dilacor XR, Tiazac,) (Treats High Blood Pressure)
    • Doxazosin (Cardura, Carduran) (Treats High Blood Pressure or Enlarged Prostate)
    • Dronedarone (Multaq) (Irregular Heartbeats) 
    • Duloxetine (Cymbalta) (Treats Depression and certain nerve pain disorders)
    • Erythromycin (Erythrocin, Ery-Tab, E-Mycin, Eryc) (Antibiotic)
    • Fluconazole (Diflucan) (Treats Fungal and Yeast Infections)
    • Fluoxetine (e.g., Prozac, Sarafem) (Treats Psychiatric disorders like depression) 
    • Fluvoxamine (Faverin, Fevarin, Floxyfral, Dumyrox, Luvox) (Treats OCD) 
    • Fosamprenavir (Lexiva) (Treats HIV)
    • Grapefruit juice (Makes Sildenafil less effective)
    • Idelalisib (Zydelig) (Treats Cancer–Leukemia) 
    • Imatinib (Gleevec) (Treats Cancer–Leukemia) 
    • Indinavir (Crixivan) (Treats HIV) 
    • Isavuconazonium (Cresemba) (Treats Fungal Infections) 
    • Isocarboxazid (Marplan) (Treats Depression)
  • Isosorbide Dinitrate or Monohydrate (Isordil Titradose, Dilatrate-SR, Imdur, Imdur ER, Ismo, Monoket, IsoDitrate) (Treats Heart Disease and Chest Pain) 
    • Itraconazole (Sporanox, Onmel) (Treats Fungus and Yeast)
    • Ivacaftor (Kalydeco) (Treats Cystic Fibrosis)
    • Ketoconazole (Nizoral, Extina, Ketodan Kit, Kuric, Nizoral A-D, Xolegel) (Treats Fungal Infections) 
    • Lopinavir; Ritonavir (Kaletra) (Contains Ritonavir and Treats HIV)
    • Lorcaserin (Belviq) (Weight Control) 
    • Lurasidone (Latuda) (Treats Depression)
    • Mifepristone, RU-486 (Korlym, Mifeprex) (Treats Cushing’s Syndrome and Ends Pregnancy)
    • Mitotane (Lysodren) (Treats Cancer and Cushing‘s Syndrome) 
    • Monoamine oxidase inhibitors (e.g., Azilect, Marplan, Nardil, Parnate) (Treats Depression) 
    • Nebivolol (Bystolic) (Treats High Blood Pressure)
    • Nelfinavir (Viracept) (Treats HIV)
    • Nesiritide (Natrecor) (Treats Heart Failure but is an IV drug)
    • Netupitant (Akynzeo) (Prevents Nausea and Vomiting)
    • Nifedipine (Procardia, Nifedical XL, Adalat, Procardia XL) (Heart Disease among others)
    • Nilotinib (Tasigna) (Treats Cancer–Leukemia)
    • Nitrates (Isordil Titradose, Dilatrate-SR, Imdur, Imdur ER, Ismo, Monoket, IsoDitrate) (Treats Heart Disease and Chest Pain)
    • Nitroglycerin (Nitro-bid, Nitrocot SA Capsule, Nitro-dur, Nitrostat, Nitrodisc, Nitrek transdermal, Minitran, Nitrol ointment, Transderm-Nitro, Nitro-Time, Nitrotab, NitroMist, Nitro-Par, Nitrolingual, Nitroquick, Transderm-Nitro, Nitrogard, Nitroglyn, Nitrong) (Treats Chest Pain and Heart Conditions) 
    • Nitroprusside (Nipride RTU, Nitropress) (Heart Failure and High Blood Pressure)
    • Ombitasvir; Paritaprevir; Ritonavir (Technivie, Viekira Pak) (Treat Hepatitis C)
    • Phenoxybenzamine (Dibenzyline) (Treat High Blood Pressure and Pheochromocytoma)
    • Phentolamine (Regitine, Oraverse) (Erectile Dysfunction, High Blood Pressure)
    • Phenylephrine (e.g.,Sudafed) (Decongestant)
    • Posaconazole (Noxafil) (Treats Fungal Infections) 
    • Prazosin (e.g., Minipress, Vasoflex, Lentopres, Hypovase) (Treats High Blood Pressure, PTSD, and Anxiety) 
    • Ribociclib (Kisqali) (Treats Cancer) 
    • Riociguat (Adempas) (Treats High Blood Pressure in the Arteries of the Lung)
    • Ritonavir (Norvir) (Also found in Technivie and Viekira Pak) (Treats HIV and Hepatitis C)
    • Sapropterin (Kuvan) (Treats a disorder that causes amino acid buildup in the brain)
    • Saquinavir (Invirase, Fortovase) (Treats HIV)
    • Silodosin (Rapaflo) (Treats an Enlarged Prostate) 
    • Tacrolimus (Prograft, Advagraf XL, Protopic, Hecoria) (Treats Organ Transplants)
    • Tamsulosin (Flomax) (Treats an Enlarged Prostate)
    • Telaprevir (Incivek, Incivo) (Treats Hepatitis C) 
    • Telithromycin (Ketek, Ketek Pak) (Antibiotic)
    • Telotristat Ethyl (Xermelo) (Treats diarrhea in cancer patients) 
  • Terazosin (Hytrin) (Treats High Blood Pressure) 
  • Tipranavir (Aptivus) (Treats HIV) 
  • Verapamil (Calan, Isoptin) (Treats High Blood Pressure, Angina, Irregular Heart Beats)
  • Vigabatrin (Sabril) (Treats Seizure Disorders) 
  • Voriconazole (Vfend) (Treats Fungal Infections)

You’re Back in Control

Sildenafil (Viagra) allows you to enjoy richer, more enjoyable, and ultimately more meaningful sexual experiences. That’s why it’s an important step in taking back control of your love life. But Sildenafil’s many benefits will only happen if you follow this guide and, above all, communicate with your healthcare professional. As always, if you require any further consultations or have any questions, don’t hesitate to contact us.