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Viagra Not Working

Dr. Lisa Lawless

Dr. Lisa Lawless, CEO of Holistic Wisdom
Clinical Psychotherapist: Relationship & Sexual Health Expert

Heart, Pills, Viagra Not Working

Frequently Asked Questions About Viagra

What is Viagra?

Men who have erectile dysfunction are often prescribed PDE5 inhibitors which are vasodilators and known as Sildenafil (Viagra), Vardenafil (Levitra, Staxyn), Tadalafil (Cialis), and Avanafil (Stendra). In 1998, the FDA approved Viagra, the first erectile dysfunction drug that could be taken in pill form. Viagra has helped many men who have ED get and keep an erection when they become sexually stimulated, either physically or visually.


What is Erectile Dysfunction (ED)?

Erectile dysfunction, or ED, is the medical term for impotence, the inability to get and/or keep an erection sufficient for satisfactory sexual activity. About 30 million men in the United States suffer from ED, half of whom are 40 to 70 years.


How does Viagra work?

Viagra enables many men with ED to respond to sexual stimulation. When a man is sexually aroused, the arteries in the penis relax and widen, allowing more blood to flow into the penis. As the arteries in the penis expand and harden, the veins that typically carry blood away from the penis become compressed, restricting the blood flow out of the penis. With more blood flowing in and less flowing out, the penis enlarges, resulting in an erection. If the nerves or blood vessels associated with this process aren't working properly, a man may not be able to get an erection. Viagra increases blood flow to the penis so that when a man is sexually aroused, he can get and keep an erection. When the sexual encounter is over, the erection goes away.


How well does Viagra work?

Viagra improves erections in 2/3rds of men who take it, regardless of how long they have had ED, what caused it, or how old they are. It works after about 30 minutes and lasts up to 4 hours.


Does Viagra automatically cause an erection?

No. With Viagra, you must be sexually aroused to get an erection. If you take Viagra and are not sexually stimulated, nothing will happen. You won't get an erection just by taking the pill. Viagra is not a hormone or aphrodisiac. It's a prescription medication that can improve the erectile function of some men with erection problems.


How much Viagra can I take?

Viagra comes in different doses (25 mg, 50 mg, and 100 mg). Like many medications, you may have to adjust your initial Viagra dose if it doesn't produce the desired results or you're bothered by side effects. Do not take Viagra more than once a day. If you are older than 65 years, have a serious liver or kidney problem, or are taking protease inhibitors, such as for the treatment of HIV, you may want to start at the lowest (25 mg) dose of Viagra.


How often can I take Viagra?

Viagra should not be taken more than once a day for most patients. In patients taking certain protease inhibitors (such as for the treatment of HIV), it is recommended not to exceed a maximum single dose in 48 hours.


Who should not take Viagra?

Viagra is only for patients with ED. If you're a man who uses nitrate drugs, like nitroglycerine, never take Viagra. Viagra and nitrates can make your blood pressure suddenly drop to unsafe levels. You could get dizzy, faint, or even have a heart attack or stroke.

Nitrates are found in many prescription medications used to treat angina (chest pain due to heart disease), such as nitroglycerin, isosorbide mononitrate, and isosorbide dinitrate. Nitrates are also found in recreational drugs such as amyl nitrate or nitrite "poppers." If you are not sure if any of your medications contain nitrates or if you do not understand what nitrates are, ask your health care provider or pharmacist.


Can I take Viagra with alcohol?

Drinking alcohol can temporarily impair the ability to get an erection. To get the maximum benefit from your medication, you are advised not to consume large amounts of alcohol before taking it.


Can I take Viagra after eating?

Yes, but taking Viagra after a high-fat meal (such as a cheeseburger and french fries) may cause the medication to take a little longer to start working.


What are the side effects of Viagra?

Like all medications, Viagra can cause some side effects. These are usually mild and don't last longer than a few hours. Some of these side effects are more likely to occur with higher doses. The most common side effects are headache, facial flushing, and upset stomach. Viagra may also briefly cause bluish or blurred vision or sensitivity to light. In the rare event of an erection lasting more than 4 hours, seek immediate medical help.


Can I buy Viagra on the internet?

As much as 50% of Viagra sold on the internet is fake. Dr. Nick Wilson of the University of London used near-infrared (NIR) microscopy to analyze the active ingredients in Viagra bought over the internet and found that about half of it isn't manufactured by Pfizer and contains different components or less the active ingredient sildenafil than the real thing. The pills are blue, just like you want them to be, and the packaging is identical to real Viagra.

The problem with counterfeit Viagra is that if the counterfeiters get the dose wrong and include too much sildenafil, which could lead to heart attacks. Fake Viagra is often manufactured in Thailand, India, Malta, and other countries.


What if Viagra doesn't work?

While Viagra is effective in up to 2/3rds men, it's not effective for everyone. Please see our related guides for more information and suggestions.

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