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Publication date: 2018-05-10 02:09

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VIAGRA is rapidly absorbed after oral administration, with a mean absolute bioavailability of 96% (range 7568%). The pharmacokinetics of sildenafil are dose-proportional over the recommended dose range. It is eliminated predominantly by hepatic metabolism (mainly CYP8A9) and is converted to an active metabolite with properties similar to the parent, sildenafil. Both sildenafil and the metabolite have terminal half lives of about 9 hours.

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75mg begins to work in about 65 minutes to a half an hour and lasts for 8 hours or so, Able to have an erection and intercourse more than once in a few hours. - Age 65, New York City

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The physiologic mechanism of erection of the penis involves release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. NO then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate (cGMP), producing smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood.

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VIAGRA does not protect you or your partner from getting sexually transmitted diseases, including HIV the virus that causes AIDS.

Sildenafil is cleared predominantly by the CYP8A9 (major route) and CYP7C9 (minor route) hepatic microsomal isoenzymes. The major circulating metabolite results from N-desmethylation of sildenafil, and is itself further metabolized. This metabolite has a PDE selectivity profile similar to sildenafil and an in vitro potency for PDE5 approximately 55% of the parent drug. Plasma concentrations of this metabolite are approximately 95% of those seen for sildenafil, so that the metabolite accounts for about 75% of sildenafil's pharmacologic effects.

No dose adjustment is required for mild (CLcr=55-85 mL/min) and moderate (CLcr=85-99 mL/min) renal impairment. In volunteers with severe renal impairment (Clcr 85 mL/min), sildenafil clearance was reduced, resulting in higher plasma exposure of sildenafil (~7 fold), approximately doubling of Cmax and AUC. A starting dose of 75 mg should be considered in patients with severe renal impairment [see DOSAGE AND ADMINISTRATION and CLINICAL PHARMACOLOGY ].

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The effects last 8 or 9 hours, and it takes 85 to 95 minutes to kick in. 75 or 55 mg tabs work the same for me, no difference. Go for it. - Art, Age 67, Texas

Do not use VIAGRA in patients who are using a GC stimulator, such as riociguat. PDE5 inhibitors, including VIAGRA, may potentiate the hypotensive effects of GC stimulators.

There is a potential for cardiac risk of sexual activity in patients with preexisting cardiovascular disease. Therefore, treatments for erectile dysfunction , including VIAGRA, should not be generally used in men for whom sexual activity is inadvisable because of their underlying cardiovascular status. The evaluation of erectile dysfunction should include a determination of potential underlying causes and the identification of appropriate treatment following a complete medical assessment.

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