17 PATIENT COUNSELING INFORMATION
Sildenafil 100mg is the highest dosage on offer to treat ED. But don’t go thinking that you need the highest dose in order to have the hardest erections, because that isn’t how it works. Your clinician will want to find the lowest dose of the drug that does the job.
14. Clinical Studies
The standard 'as required' Tadalafil dose is 10mg, which may be increased to a maximum of 20mg if the medication is ineffective. This dose also depends on your medical history, so your doctor will discuss the appropriate starting dose with you. The daily version of Tadalafil known by its brand name Cialis Daily, is recommended for those who have sex more than twice a week. The medication is taken every day and after approximately 5 days, should have its full effect. By taking the medication in this way, there is a steady, constant dose in the body.
6.2 Postmarketing Experience
This gives the individual even more spontaneity. The initial dosing is 2.5mg once daily, which can be increased to 5mg if the initial dosing is ineffective. One of the disadvantages of Tadalafil is that as the medication lasts in the body for longer, if you get side effects with the medication, these can last longer as well. The side effects are similar to all ED medications - headache, nausea, stuffy nose, flushing, indigestion, but as mentioned before there can be some other rarer side effects; you should always check the leaflet that comes with the medication before taking it. Different ED medications suit different people so it is difficult to tell which would work best for you until you’ve tried each one. This is to help keep the likelihood of side effects as low as possible. Your sildenafil dosage may be increased to 100mg if the lower dosage has not had the desired effect. What works well for you might not work well for someone else with ED.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Viagra Generic | 150mg | 10 Pills | 36.73€ 34.98€ | |
| Viagra Generic | 200mg | 90 + 6 Pills | 170.79€ 162.66€ | |
| Kamagra Soft Tabs | 100mg | 32 Pills | 120.11€ 114.39€ | |
| Viagra Generic | 150mg | 20 Pills | 55.02€ 52.40€ | |
| Kamagra Soft Tabs | 100mg | 120 + 6 Pills | 311.78€ 296.93€ | |
| Viagra Generic | 25mg | 360 + 10 Pills | 213.68€ 203.50€ | |
| Kamagra Oral Jelly | 100mg | 110 + 9 Sachets | 334.87€ 318.92€ | |
| Kamagra Soft Tabs | 100mg | 12 Pills | 57.55€ 54.81€ | |
| Viagra Generic | 200mg | 270 + 10 Pills | 379.76€ 361.68€ | |
| Viagra Generic | 50mg | 20 Pills | 40.52€ 38.59€ | |
| Kamagra Polo | 100mg | 120 + 6 Pills | 327.15€ 311.57€ | |
| Viagra Generic | 25mg | 20 Pills | 37.74€ 35.94€ | |
| Viagra Generic | 150mg | 60 + 4 Pills | 111.25€ 105.95€ | |
| Viagra Generic | 25mg | 180 + 6 Pills | 154.93€ 147.55€ | |
| Kamagra Oral Jelly | 100mg | 90 + 8 Sachets | 303.56€ 289.10€ | |
| Viagra Generic | 150mg | 360 + 10 Pills | 423.48€ 403.31€ |
The availability of different sildenafil citrate dosages allows prescribers to level up and down where required.
Drug Label Information
It offers a great starting point, with 74% of patients in a fixed dose study reporting improved erections when using 50mg. This dosage may be recommended if you have not tolerated Viagra well in the past, often highlighted by unwanted side effects. If you need to reduce your dosage to 25mg then don’t be put off, because a study still found 62% of participants that used this dose reported an improvement in their erections. Sildenafil (or generic Viagra) is also available at a slightly lower dose than this, at 20mg. It’s primarily used for pulmonary arterial hypertension, but doctors also prescribe it to men who need a lower dose to treat erectile dysfunction. Your own personal recommended dose of Viagra will take lots of things into account, including your past medical history and current health and medications.
| Brand Name | Company | Formulation Type | Price Range |
|---|---|---|---|
| Viagra | Pfizer | Tablet | $10–$25 per pill |
| Kamagra | Ajanta Pharma | Generic | $2–$7 per pill |
| Sildenafil RX | Various pharmacies | Various generics | $3–$9 per pill |
| Revatio | Pfizer (for pulmonary hypertension) | Same strength, different use | Varies |
The Sildenafil 25mg dose can be a good starting point for men over the age of 65 with other medical conditions.
Brand names
If you’re using the standard sildenafil dosage for ED and don’t feel like you’re quite realizing your “erectile potential,” then you should think about speaking to your prescriber to switch up your sildenafil dosage. There are three different Sildenafil dosages prescribed for the treatment of erectile dysfunction. The different Viagra strengths give the option to raise or lower the amount of active ingredient (sildenafil citrate), depending on how your body reacts to the treatment. Sildenafil 50mg is the middle dose and the one that most men will be introduced to. Starting here gives your clinician the opportunity to increase or decrease the dosage depending on how your body reacts to the treatment. If you’re being introduced to Viagra for the first time you’ll likely start with the sildenafil 50mg tablet. This is the median dose and is the recommended dose of Viagra for most men. The Viagra 50mg dose can improve erection results but, because this dosage is the midpoint, it leaves room for a dosage change to be made if required. It’s often referred to as the normal Viagra dose and that’s probably because, as we’ve mentioned, it is quite normal to start on 50mg.
What other information should I know?
Stop sexual activity and seek medical attention if you experience symptoms such as chest pain, dizziness, or nausea during sex, or if you have any side effect that bothers you or does not go away. Use protective measures to guard against sexually transmitted diseases, including the Human Immunodeficiency Virus (HIV). Sildenafil and Tadalafil are the most well-known of all the ED medications. They are both in a class of medications called ‘phosphodiesterase type 5 (PDE5) inhibitors’ and work in a very similar way. These medicines work in the presence of sexual stimulation.
7.2 Alpha-blockers
Once aroused, a natural chemical is released, which the PDE5 inhibitors rely on to work with. Once this natural chemical is released, a chain reaction begins, relaxing the smooth muscle inside the penis. There is then an increase in blood flow into the penis allowing the penis to can become erect. Sildenafil has been around since 1998, which means a lot is known about the positive effects and also the side effects. It works within an hour of taking the medication and for its full effect, should be taken on an empty stomach. For this reason the non-prescription Viagra Connect dosage is also set at 50mg.
Liver Dose Adjustments
In our experience, men often prefer Tadalafil as it lasts longer, works faster and can be taken with food. Having said that, some men find that Tadalafil does not suit them, so they prefer to stick with Sildenafil. You can request both Sildenafil and Tadalafil safely online through the LloydsPharmacy’s Online Doctor service. If appropriate, our GPs can prescribe you treatment for next-day delivery, ParcelShop collection or FREE standard delivery. If you’re unsure which ED treatment will be best for you then take our free ED assessment and our clinicians will help you decide.
Why it’s used
Finding the right Viagra dosage can take a little time but the potential benefits definitely make it worthwhile. You might start on the 50mg sildenafil dose but other dosages are available. There are three Viagra doses in total. The highest contains 100mg of sildenafil, and the lowest contains 25mg. It’s the ‘middle’ sildenafil dose of 50mg that’s the recommended sildenafil citrate 150 mg red pill starting point for most men. This is an accessible starting point for many men, where they don’t have to attend a doctor consultation.
What side effects can this medication cause?
The effects of Sildenafil generally last for four to five hours. Viagra was developed by the pharmaceutical company Pfizer and they were the only company that could legally manufacture it until 2013. In 2013, their patent expired which meant that other companies could produce their own erectile dysfunction medications containing the active ingredient sildenafil. When you see the medication ‘Sildenafil’, you can be assured that it contains exactly the same active ingredient as Viagra. However, as it is a generic version rather than the brand, it is considerably cheaper.
5.8 Effects on Bleeding
The more common side sildenafil softgel capsule effects of Sildenafil can include headache, nausea, stuffy nose, flushing and indigestion. There are also some rarer side effects; you should always read the accompanying leaflet that comes with any medicine before taking it. Sildenafil is taken on an as needed basis, usually at a dose of 50mg. These may be increased to 100mg if the standard dose is ineffective, or lowered to 25mg if mild side-effects are experienced. The dosing may be different depending on your medical history, so your doctor should discuss an appropriate starting dose with you. The 100mg dosage is never used as a starting point for men new to Viagra. There should be no need to start on the highest dosage.
| Drug Class | Interaction Effect | Recommendation |
|---|---|---|
| Nitrates | Severe hypotension | Avoid combination |
| Alpha-blockers | Additive blood pressure lowering effect | Use with caution |
| CYP3A4 inhibitors (e.g., ketoconazole) | Increased sildenafil levels | Dose adjustment may be necessary |
| Antihypertensives | Enhanced blood pressure reduction | Monitor blood pressure |
| Grapefruit juice | Increased plasma concentration | Avoid during treatment |
Whilst Viagra 50mg tablet sildenafil 50 mg tends to be the normal Viagra dose to start on, this isn’t the case for everyone. Sometimes a lower starting dose of 25mg will be suggested by a clinician.
If you take too much
Sign up and enjoy newsletters filled with advice from our clinicians, offers and more. In 2003, a company named Eli Lilly introduced Cialis as an alternative ED medication. The company had the patent on Tadalafil until November 2017. Similarly to Viagra, now that the patent has expired, other companies are permitted to make their own version of Tadalafil, the active ingredient in Cialis. Again, as it is a generic version of the brand, Cialis, the medication is considerably cheaper.
Vybrique Oral Film
Tadalafil has two formulations – one that can be taken 'as required', and one that can be taken daily. The 'as required' Tadalafil (generic Cialis) has an advantage over Sildenafil in that it lasts a lot longer – up to 36 hours (compared with 4-5 hours for Sildenafil). Some men prefer this as it allows for more spontaneity. Tadalafil also works faster than Sildenafil – it generally works within 30 minutes, though for some men it can take up to an hour. The action of Tadalafil is not affected by food, and this is another reason why some men may prefer it. This route may be considered if you’re already taking certain medications for the treatment of kidney, liver or heart conditions. Or if your previous tolerance of sildenafil citrate 50mg was low. The highest dose is reserved for particular cases where the generic Viagra dosage of 50mg has already been found to be lacking.
| Country | Prescription Requirement | Over-the-Counter Availability | Regulatory Body |
|---|---|---|---|
| USA | Yes | No | FDA |
| UK | Yes | No | MHRA |
| Canada | Yes | No | Health Canada |
| Australia | Yes | No | TGA |
| India | Yes (in some states) | Some brands available OTC | CDSCO |
Some men will experience unwanted side effects even on the median dose of Viagra. This sort of problem can sometimes be resolved by moving to the lower dose. When treating ED, the next dose down is 25mg. Your doctor will discuss making this change with you. Don’t try to split pills, as they’re not scored for splitting and doing so can lead to an inaccurate dose. “In between” doses aren’t licensed for the treatment of ED in the US.
- Numerous drug interaction studies have been conducted with sildenafil.
- Co-administration with nitrates causes synergistic blood pressure lowering.
- This interaction can lead to life-threatening hypotension and cardiovascular collapse.
- Alpha-blockers (e.g., tamsulosin) can enhance the blood pressure-lowering effect.
- A separation of at least 4 hours between alpha-blocker and sildenafil dose is advised.
- HIV protease inhibitors significantly increase sildenafil AUC (up to 11-fold).
- A maximum sildenafil dose of 25mg in a 48-hour period is recommended with ritonavir.
- Other CYP3A4 inhibitors require similar dose reductions and cautious use.
- No significant interaction was observed with tolbutamide, warfarin, or alcohol.
- Alcohol can increase the potential for orthostatic hypotension and dizziness.
- Always assume a potential interaction exists with any new medication.
For example, Sildenafil 40mg is not used to treat erectile dysfunction. Some of the more common side effects linked to sildenafil include headache, facial flushing, a stuffy nose, visual changes or dizziness. If you experience mild side effects, you may feel that the benefits outweigh the cons. However, should you experience a more serious side effect, such as a prolonged erection (priapism) or vision loss, then you need to seek immediate medical attention.
- 20mg sildenafil provides a balance between effectiveness and safety.
- It is not a cure for ED but helps achieve and maintain an erection.
- Using sildenafil without medical advice can be risky.
- The medication may cause nasal congestion or stomach upset.
- Always follow the dosage instructions provided by your healthcare provider.