In order to fully understand a medication, it is important to be informed on how it works in the body. This is referred to as the mechanism of action and is crucial in bringing the desired effects into play when taken.
To comprehend the mechanics of how does sildenafil work and how it produces its beneficial effects in treating erectile dysfunction (ED) is to know how an erection is formed. An erection is the hardening of the penis as a result of increased blood flow. It causes the penis to expand and stand away from the body.
An erection will only occur when the male is sexually stimulated. After stimulation, the chemical cGMP (cyclic guanosine monophosphate) is secreted and released into the body. This chemical is responsible for relaxing the smooth muscle tissue found in the penis.
cGMP promotes increased blood flow to the penis and ensures it stays there, which induces an erection. After sexual intercourse or some time, the enzyme phosphodiesterase type 5 (PDE-5) is released to subside the erection. It does this by expelling the cGMP chemical from the penis. In this way, the blood that was trapped there is released, causing the erection to lessen.
In patients with ED, there is an excess of the PDE-5 enzymes, making it difficult to get and maintain a rigid erection. However, the effects of sildenafil inhibit the function of these enzymes, facilitating the process of an erection. The medication will allow cGMP to remain in the penis, which causes a rigid erection.
Patients must remember that taking the medication will not instantly cause an erection as they require adequate sexual stimulation. This means that patients will not have a constant or permanent erection after taking the medication.
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Are the Effects of Sildenafil Similar to Viagra?
Sildenafil citrate is the active substance present in both the brand and generic forms. This means that both of them are bioequivalent. Bioequivalence is a common term used in pharmacokinetics to define two products for identical intents and purposes with the same composition.
The generic medicines are approved by the Food and Drug Administration (FDA) and have to undergo various testing and trials to ensure their bioequivalence to Viagra and overall safety.
These generics only differ from their branded name in the following ways:
- Pfizer, Viagra’s parent company, does not manufacture them.
- The prices are lower than Viagra.
- Generic pills are typically white, not blue.
- Sildenafil is approved to treat ED and pulmonary arterial hypertension (PAH).
These differences do not affect the effects of the generic medication at all. The generic produces the same desirable results as Viagra at a more cost-effective price. Despite contrary belief, generics do not increase the risk of adverse events (AEs).
The effects of these generic medications do not facilitate spontaneous erections. Just like the effects of Viagra, arousal and stimulation are still required to achieve an erection. The use of the medication is to make it easier to achieve and maintain it.
What Dose of Sildenafil Should I Take?
The overall goal of this medication is to find the perfect dose that delivers a satisfactory erection. It is not to find the highest tolerable dose of the substance but instead to find a safe and effective dose for the patient.
This tablet is available in doses of 20mg, 50mg, 80mg and 100mg. The availability of these doses allows patients to choose a dose that works for them, as certain conditions may impact their ability to absorb the substance.
It is best to start on a small dose of sildenafil, 20mg or 25mg, taken 1 hour before sex. The recommended dose is 50mg afterwards, however, most patients who titrate to 100mg for improved effectiveness do not experience a surge in side effects.
According to a study, this medication taken at 50mg or 100mg improved the quality of erections, satisfaction of the treatment, anxiety levels and the overall sexual experience equated with the placebo. Both these doses were well-tolerated.
What to Expect from this ED Treatment?
Patients who take this medication for the first time naturally have many questions about what to expect when they take the pill. The active ingredient in sildenafil is sildenafil citrate, which works by promoting muscle relaxation and vasodilation. This allows an increased level of blood flow to the penis, facilitating a firmer erection, resulting in satisfying sexual intercourse.
A common myth around this medication is that it will induce an erection as soon as it is taken. In actuality, sexual arousal and stimulation are necessary for the tablet to take effect. Usually, it takes approximately 30 minutes of foreplay or gentle masturbation before achieving an erection rigid enough for penetrative sex.
A firm erection can be achieved in a minimum time of 12 minutes of stimulation, whereas it can take an hour for other men. This is to show the differences between various patients and their bodies. It is essential to relax and focus on the experience instead of stressing. Stress may inhibit the patient from becoming aroused, negatively impacting the medication’s effectiveness.
The effects of the medication would peak within 30 minutes to 2 hours post-ingestion. These effects can remain for 4 hours or even longer in some patients. At this time, the patient can achieve multiple erections, allowing for spontaneous sexual activities.
Can this Medication be Used Long-Term?
The safety and overall side effects profile of this medication is impressive and proves to be well-tolerated. The most reported side effects at therapeutic doses include facial flushing, dizziness, headache, nasal congestion and abnormal vision.
These side effects have a mild expression and are usually dose-related. They do not warrant a change in medication. The medication is approved for ED in the maximum dose of 100mg in each situation. However, some cases can warrant the use of higher doses of 240mg daily.
This has been safely used in those with severe ED, pulmonary hypertension or ejaculatory delay. The active ingredient in sildenafil is safe to be taken every day, beginning at 25mg or 50mg as a single dose. Patients must always adhere to recommendations and any instructions to ensure continued beneficial effects from this medication.