Introduction: Sildenafil citrate has been used worldwide by men with erectile dysfunction. The prescribing information for sildenafil suggests ingestion 1 hour before sexual activity and also notes reduced maximum plasma concentration and delayed time to maximum concentration following ingestion with a high-fat meal. The clinical impact of coingestion of food and these factors has never been evaluated.
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Aim: To determine, using a naturalistic study design, whether sildenafil taken 1 hour before or during a meal compared with usual ingestion 30-60 minutes before sexual activity affects efficacy or patient satisfaction.
Methods: After a 1-2-week washout, 48 men (29-79 years old), currently satisfied with sildenafil, followed each of four regimens: (A) sildenafil 1 hour before a meal and placebo 30-60 minutes before planned coitus vs. (B) placebo 1 hour before a meal and sildenafil 30-60 minutes before coitus; and (C) sildenafil during a meal and placebo 30-60 minutes before coitus vs. (D) placebo during a meal and sildenafil 30-60 minutes before coitus. Subjects were not instructed to change their regular dietary habits during the course of the study.
Main outcome measures: Change from baseline in the International Index of Erectile Function (IIEF) Erectile Function (EF) domain score, responses to Sexual Encounter Profile (SEP) questions 2 (erection sufficient for penetration) and 3 (erection sufficient to complete intercourse), and measures of patient preference and satisfaction.
Results: Mean changes in IIEF-EF domain scores were 11.4 for regimens A and B and 11.2 for C and D. Positive SEP2 responses were recorded for 93.9% and 91.8% of intercourse attempts in A and B and 91.4% and 92.6% in C and D. Corresponding results for SEP3 were 84.7% and 85.9%, and 83.4% and 87.5%, respectively. There were no significant differences between pairs of treatments on satisfaction. The time between sildenafil ingestion and intercourse attempt (0-0.5 to >10 hours) had no significant effect on responses to SEP2, but decreased responses to SEP3 from a maximum of 92.8% at 1.5-2 hours to 81.6% at more than 10 hours (P = 0.003).
Conclusions: No significant loss of efficacy occurs when sildenafil is taken shortly before or with a meal. The duration of action for sildenafil may exceed 10 hours.
Viagra (active ingredient sildenafil) is a highly effective, FDA-approved medication used to treat erectile dysfunction (ED). But like any other medication, it’s not a magic pill. If Viagra isn’t achieving the results you desire, you can make changes to make Viagra more effective. Taking the pill at the right time, not taking it on a full stomach, and avoiding taking it with drug or alcohol use all might improve the effectiveness of the medication. Lifestyle changes and healthy habits may also make Viagra more effective.
Whether you’re taking Viagra for the first time or you’re a seasoned pro, continue reading to learn how to make Viagra work best for you.
Viagra treats erectile dysfunction by stopping the chemical reaction that causes blood to leave an erect penis—this is key to understanding how to make Viagra more effective.
More specifically, Viagra is a member of a class of drugs called PDE-5 inhibitors. These work by blocking an enzyme called PDE-5, which encourages blood to flow out of the penis. When PDE-5 is blocked, it keeps the blood vessels in the penis open, allowing blood to flow into the penis more freely, making it easier to get and maintain an erection.
PDE-5 inhibitors like Viagra don't cause an erection automatically. Sexual arousal is necessary to get an erection on Viagra. So, the first step you can take to boost the effects of Viagra is to set the mood.
Viagra Important Safety Information: Read more about serious warnings and safety info.
Several factors can influence how quickly and effectively Viagra works once you take it. Here are some tips that can really help Viagra do its thing.
If you take Viagra on a full stomach—particularly if you’ve had a heavy, high-fat meal—the medication may take longer to work.
A full stomach can delay your body's absorption of Viagra by up to an hour, meaning your erection might come later than expected, be less strong than you want, or not last as long as you’d like. This doesn't necessarily mean you need to take Viagra on an empty stomach, but be mindful of taking it too close to full, heavy meals.
While it’s safe to drink alcohol with Viagra in moderation, drinking may make it more difficult to get an erection. Alcohol is a depressant that affects many different systems in the body, including those involved in producing an erection.
Alcohol, as well as marijuana and other drugs, can worsen ED symptoms. Chronic heavy drinking damages the liver, heart, and nerves, as well as reduces testosterone—all of which can lead to ED and make it more difficult for Viagra to achieve its desired effect.
When it comes to medication, more is not necessarily better. But, if you’re taking Viagra exactly as you're supposed to and it still doesn’t work for you, adjusting the dose or switching to a different prescription medication might help. Speak to your healthcare provider so they can make the appropriate adjustments to your prescription (and never take more Viagra than is prescribed to you).
Ideally, Viagra should be taken 30–60 minutes before you plan to have sex for best results. It needs time to work, so taking Viagra too close to the time that you need it may make it more difficult to get an erection strong enough for satisfying sex.
Taking Viagra too early may do the same. Because Viagra works for about four hours before wearing off, taking it too far in advance of sexual activity (say, in the morning when you plan to have sex at night) might not lead to the erection you want. If you’re new to Viagra, try it out a couple of times solo to see how it affects you. Knowing how you react to Viagra might take some pressure off when it comes to partnered play.
Viagra (and erections in general) work best when you're healthy. A healthy body—particularly a healthy heart—is your best asset in overcoming ED.
Since an erection requires good blood flow, anything that hinders blood flow makes getting an erection more difficult. That’s true even if you take Viagra. The best way to get longer-lasting, stronger erections is by improving blood flow and blood pressure and maintaining healthy hormone levels. You can keep your heart healthy with these tips:
Get enough cardiovascular exercise. A sedentary lifestyle is a major risk factor for erectile dysfunction, especially because it can contribute to heart disease, high blood pressure, and other medical conditions that affect blood flow. One study found that men who were inactive or moderately active (less than 150 minutes of physical activity a week) were as much as 60% more likely to experience ED than men who got at least 150 minutes of physical activity each week.
Maintain a healthy weight. A large, multi-year study found that obesity nearly doubles a person’s risk for ED. Obesity is also a risk factor for type 2 diabetes, which can damage nerves and blood vessels throughout the body. This includes those that supply the penis, which can result in ED.
Don’t smoke. Tobacco smoke contains thousands of toxins that can damage the lining of the blood vessels in your body, including the penis. Research has linked cigarette smoking to erectile dysfunction and shown that stopping smoking can help improve symptoms of ED.
If you’re not satisfied with the results of your Viagra, it’s likely you’ve taken to the internet for tips to make the medication work faster (you’re here, after all). While some tips and tricks promise to help you get an erection faster, there is no way to speed up the process of Viagra if you are already taking the medication as prescribed. Here are some myths about making Viagra work faster.
Does chewing make Viagra work faster? The answer is no. These pills are not made to work that way and should be swallowed as a whole, as recommended by the manufacturer of the medication. If you chew your Viagra, the time it takes to fully process the pill either stays the same, or it may even cause the medication to take even longer to help you achieve an erection.
Viagra (and its generic counterpart, sildenafil) are meant to be swallowed, not dissolved under the tongue. Viagra must pass through the digestive tract in order to work properly. There are sublingual (under the tongue) options on the market that contain sildenafil and other PDE-5 inhibitors.
While Viagra is extremely effective to help you get or maintain an erection, unfortunately, it doesn’t increase your libido. Sexual arousal is needed for the pill to do its job. If you struggle with low libido or mismatched libido with a partner, speak to your healthcare provider. They may refer you to a sex therapist or explore other medical options to increase your sex drive.
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All medications have the potential to cause side effects, and ED medications like Viagra are no different. Common side effects of Viagra tend to be mild and include:
Dizziness
Headache
Flushing
Upset stomach or indigestion
Abnormal vision (increased sensitivity to light, blurred vision, or blue-tinted vision)
Nasal congestion or runny nose
Back pain
Insomnia
Rash
Muscle pain
Serious side effects of Viagra are less common but require urgent medical attention if experienced. These include:
Priapism (a prolonged, painful erection that won't go away)
Chest pain
Sudden vision loss
Ringing in ears or hearing loss
Seizures
Swelling in your arms or legs
If you’re taking Viagra but haven’t achieved the desired effects, these tips may make the medication more effective. If all else fails, a different dosage or alternative medication might be a better fit. Speak with your healthcare provider to learn how you can get the most out of your erectile dysfunction medication.
DISCLAIMER
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
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Zucchi, A., Costantini, E., Scroppo, F. I., et al. (2019). The first-generation phosphodiesterase 5 inhibitors and their pharmacokinetic issue. Andrology , 7 (6), 804–817. doi:10.1111/andr.12683. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31350821/
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