Sildenafil will remain in the blood for longer than 4 hours but usually at concentrations too low to be effective (see graph below). If effects last longer than 4 hours it is usually because the dosage taken is higher than required, with the drug remaining effective in the blood for longer.
| Region | Mailing Restrictions | Impact on Price | Notes |
|---|---|---|---|
| USA | Prescription required | Higher due to legal process | Adds to overall cost |
| EU | Prescription needed | Similar to USA | Certification process can add fees |
| India | Over-the-counter sale available | Lower overall prices | Less restrictive, cheaper options |
| Canada | Prescription only, import restrictions | Possible higher costs due to import taxes | Regulations impact availability and cost |
Taking sildenafil shortly after eating a meal, particularly a meal high in fat, can delay the effects. It is advised to use the lowest effective dose which will reduce possible side effects. For further information read How long does sildenafil last? In some cases ED is associated with high blood pressure or cholesterol, poor circulation, obesity, lack of exercise, smoking, and diabetes, and these are also risk factors for heart disease and stroke. Men with ED need to be examined and tested before starting treatment. It is fine to obtain repeat supplies of sildenafil online, but this does not replace a face-to-face visit to a doctor.
If sildenafil is taken in combination with recreational drugs, particularly cocaine, there is an increased risk of adverse effects, particularly prolonged painful erections, which can lead to permanent damage to the penis (priapism). The Patient Information Leaflet (PIL) is the leaflet included in the pack with a medicine and must be read before taking the medicine. It is written for patients and gives information about taking or using a medicine. Different pharmacy companies produce their own sildenafil tablets. Dr Fox supplies only UK licensed tablets supplied from UK registered pharmacies. Most men do not seek medical help for their ED because of embarrassment or social stigma that may lead some men to self-treat. Before ordering sildenafil online men must first read medical information about erectile dysfunction and answer medical questions to check for eligibility. Our doctors will then review your information before prescribing, and are available to answer any questions you may have. Studies suggest that men are capable of using written sildenafil patient education materials to accurately assess their suitability for treatment with 50mg sildenafil. Sildenafil is the medical name for the active ingredient in both.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Kamagra | 100mg | 360 + 6 Pills | 839.95€ 799.95€ | |
| Kamagra Polo | 100mg | 12 Pills | 60.21€ 57.34€ | |
| Viagra Generic | 100mg | 30 + 4 Pills | 60.91€ 58.01€ | |
| Viagra Generic | 100mg | 360 + 10 Pills | 330.21€ 314.49€ | |
| Viagra Generic | 200mg | 30 + 2 Pills | 83.07€ 79.11€ | |
| Viagra Generic | 100mg | 10 Pills | 28.91€ 27.53€ | |
| Kamagra | 100mg | 32 Pills | 121.24€ 115.47€ | |
| Viagra Generic | 200mg | 120 + 8 Pills | 204.80€ 195.05€ | |
| Viagra Generic | 200mg | 10 Pills | 40.96€ 39.01€ | |
| Viagra Generic | 200mg | 180 + 10 Pills | 277.56€ 264.34€ |
Sildenafil and Viagra both come in packs of 4 and 8 tablets in strengths of 25mg, 50mg, and 100mg. They are equally effective and have the same side effects and other features. All four are from the same class of medicine (PDE5 inhibitors) and work in the same way. They are all equally effective, but have different durations of action. Sildenafil is most suitable for men intending to be sexually active within a few hours of taking a tablet, after which time the effects will wear off. Sildenafil is relatively cheap to produce and is supplied by a number of competing drug companies. Viagra, which is simply Viatris's brand of sildenafil, is supplied by Viatris alone. Viatris has chosen to keep the price of Viagra higher and can still find a market as some men are loyal to the Viagra brand. Sildenafil is a medicine for which the patent has expired.
The normal starting dose, in men who have not taken sildenafil before, is one 50mg tablet. Subsequent doses can be adjusted up to a maximum of 100mg as a single dose, or down to 25mg, depending on response. Sildenafil should not be taken more than once in 24 hours. The effects of treatment may not be exactly the same each time. It is best to take the same dose that worked previously, increasing the dose only if on several occasions treatment is not successful.
Reduced dose recommended when 50mg starting dose is highly effective. Starting dose usually recommended for most men taking sildenafil for the first time. High strength dose for when 50mg is ineffective. All men with erectile dysfunction should consult a doctor face-to-face before buying sildenafil tablets online. Sildenafil is not suitable for all men, particularly men who have severe heart disease or a history of stroke. This means the pharmaceutical company which developed it, Viatris, cannot prevent other companies producing it. There is a big demand, and over a dozen pharmaceutical companies produce and market their own sildenafil.
The following are UK licensed manufacturer brands: Accord/Actavis, Amarox, Bristol Labs, Crescent, Dr Reddys, Eurolink,Genesis, Macleods, Milpharm, Mylan, Teva, RxFarma, Sandoz, Somex, Viagra, Viagra connect, Zentiva, Pfizer. Only buy from registered pharmacies to guarantee tablets meet standards. If you obtain sildenafil from UK regulated websites and pharmacies there will be no difference.
The active ingredient in one 25mg tablet of any brand of UK licensed sildenafil will be the same as any other. The appearance, shape, and colour may vary, but the active ingredient will be the same.
| Side Effect | Occurrence Rate | Additional Cost | Management Option |
|---|---|---|---|
| Headache | 20% | None | OTC pain relievers |
| Flushing | 15% | None | Usually self-limiting |
| Dizziness | 10% | Possible medical consultation | Monitoring, reduced dose |
| Vision Changes | 5% | Medical visit | Prescription adjustment |
Men often have a preference for one brand over another, but usually find that when their preferred brand is not available, they are just as happy with the alternative.
Some prescribed medicines interact with sildenafil, most notably medicines called nitrates, used to treat angina and heart disease. Checks on the suitability of treatment are carried out during our online consultation. Men who are not eligible to order from Dr Fox should consult with their usual doctors. Men should not take sildenafil without further assessment from their GP when the following apply: Allergies or reactions to past ED treatments. Recent heart attack (within 90 days) or suffer from angina (heart pain on exertion) or severe heart disease.
Recent stroke or mini-stroke/TIA (within the last 6 months). History of vision problems caused by circulation problems. History in the family of rare degenerative eye disease. Peyronie's disease - angulation or deformity of the penis. Leukaemia, multiple myeloma or sickle cell disease. See generic sildenafil brand preference survey report and brands of sildenafil pages for further information. Since April 2018 pharmacies can supply Viagra Connect (sildenafil 50mg) without a prescription, although this is significantly more expensive. Lower cost generic sildenafil 50mg is also now available over the counter without a prescription.
Current active stomach ulcers (peptic ulcer or gastric ulcer). Most men find sildenafil effective and do not experience significant side effects. The commonest side effects, affecting up to 1 in 10 men are, nausea, facial flushing, hot flush (symptoms include a sudden feeling of heat in the upper body), indigestion, colour tinge to vision, blurred vision, visual disturbance, stuffy nose and dizziness. A complete list of side effects can be found in the manufacturer's patient information leaflet. Allergic type reactions, chest pains or fits, all of which are very rare, require immediate medical attention.
Prolonged (2 hours or more) painful erections, a medical condition called priapism, is rare but also and requires immediate medical attention. For more information see side effects of Viagra/sildenafil. There is no single factor which causes ED. The most frequent cause is impaired circulation, which comes in part with ageing. Factors which impair circulation include smoking, lack of exercise, and obesity. Original Viagra and some other generic sildenafil remain a prescription only medicine which can be dispensed legally only from registered pharmacies.
Some medical conditions, most notably diabetes, are associated with ED. ED can also occur as a side effect of some prescribed medicines. Operations and trauma, which damages the nerves or blood supply to the penis, can result in ED. This is by no means a complete list. Sildenafil tablets support and help natural erections.
If ED is caused by severely restricted circulation or damage to the nervous system, tablets may not help. There are alternative non-tablet treatments, including Vitaros cream, and various other locally applied treatments. Some men benefit from counselling, particularly if stress and performance anxiety are present. A GP should be able to advise. Most men take sildenafil to support their usual sexual activity, with resulting benefits to their relationships. UK online pharmacies use electronic prescriptions issued by doctors or specialist pharmacists. When you order medicine from Dr Fox a prescription is issued electronically to our licensed pharmacy, so you do not need a paper prescription from your own doctor. Use only registered pharmacies, as unregulated suppliers are not subject to controls and will be selling fake medicine which may be ineffective and possibly dangerous. Yes, GPs can prescribe sildenafil, but usually do so in only limited amounts in line with strict eligibility criteria. In some cases it will cost less to buy sildenafil online than obtaining it repeatedly through the NHS where the prescription fees may be higher. Some brands of sildenafil tablets used to be scored to enable them to be cut or broken in two easily, however these have been discontinued. All sildenafil tablets are now un-scored and can be difficult to split without crumbling.
| Preference | Percentage (%) | Notes |
|---|---|---|
| Generic over Brand | 65 | Cost-saving option |
| Purchase Online | 70 | Convenience and lower price |
| Brand-name preference | 30 | Trust and efficacy |
| Bulk Buying | 25 | Cost efficiency |
Purchasing a pill-splitter can help the process. It is best not to drink alcohol when taking sildenafil or to drink only a small amount (one or two units).
The following pharmaceutical companies produce sildenafil: Accord, Actavis, Amarox, Bristol Labs, Crescent, Dr Reddys, Genesis, Milpharm, Mylan, Teva, RxFarma, Sandoz, Somex, Zentiva, Perrigo, Pfizer, and others. Most erectile dysfunction tablets contain Lactose - Mylan sildenafil and Teva sildenafil are manufacturer brands that do not contain Lactose. Generic medicines supplied may change from time to time as manufacturers may have stock shortages, and generic manufacturer switching is often unavoidable. Most men find no difference between generic medicines. Patients with sildenafil gel a preference can request a specific generic manufacturer when ordering. Alcohol is a depressant and tends to reduce erections and will reduce the effectiveness of treatment. Some side effects of sildenafil are likely to increase with alcohol, particularly low blood pressure. Sildenafil is usually effective and usually remains effective at the same dose over many years.