Things to know about Viagra

Much of what's sold over the internet as Viagra or other similar drugs is fake.

Dose

These drugs start to work 30 minutes after being taken.

A 50mg dose of viagra is the preferred starting dose. Higher doses don't necessarily mean a stronger effect: 200mg works no better than 100mg but does mean stronger side-effects.

Viagra and similar drugs will not work as well after a fatty meal or with alcohol and should not be taken more than once in a 24 hour period.

The down side

The effects can last from four hours to 36 hours, depending on the type of drug. This doesn't mean erections will last that long. Any man with an erection lasting more than four hours should go to hospital as it can cause permanent damage. Cialis is reported to have the longest effect (several days).

Minor side-effects (which increase the higher the dose) include:

• headache
• upset stomach
• blocked nose
• flushed face and chest
• vision with a blueish tinge.

Problem use

Viagra is not addictive but men can come to rely on it to give them sexual confidence.

At risk

More dangerous (but rare) side-effects can be temporary or permanent blindness, stroke, heart attack or death. These are seen more in men who:

• are older
• are overweight
• are diabetic
• have high/low blood pressure
• have heart disease
• have glaucoma (an eye condition)
• have had a stroke or heart attack.

You should avoid Viagra and similar drugs, or consult your doctor before trying them, if you:

• are taking protease inhibitor drugs for HIV (a lower dose than usual is often needed)
• are on alpha blockers for high blood pressure or drugs containing nitrates for heart problems
• have uncontrolled abnormal blood pressure
• have had a stroke or heart attack
• have problems with blood pressure in the eye
• have been told by a doctor not to have sex for health reasons.

These drugs don't work for a quarter to a third of men taking them; failure may be down to anxiety. Some men experience different levels of success, depending on the drug they use.

The drugs work best with men whose erection problems are mental/psychological and may be used as a short-term boost that restores their ability to get erect without any further help. Men have a lower response to the drugs if their erection problem has a physical cause such as diabetes, heart disease or abnormal blood pressure or who have had their prostate removed.

Erection difficulties can be due to tiredness, lack of testosterone (seen in some men with HIV), alcohol and drug use, depression and stress. They can often be improved by losing weight, stopping smoking and getting more exercise. Get more info on erection problems.

Mixing

With poppers

There have been deaths when men have used Viagra-type drugs while on nitrate-based medication in pill form for heart problems. This is because both drugs lower blood pressure and together the drop can be fatal. Poppers contain nitrites and also lower blood pressure, so advice is to avoid sniffing poppers after taking Viagra or any siilar drug for up to 48 hours until the drug has left the body.

With ecstasy

The combination of Viagra and ecstasy (known as 'sextasy') involves crushing the pills of both drugs, then snorting them, or swallowing both pills together. This counteracts how ecstasy and other drugs like cocaine or crystal meth often interfere with erections.

The lowering of inhibitions associated with E and these other recreational drugs, combined with increased ability to perform sexually, can put men at greater risk of unsafe sex and picking up sexually transmitted infections.

Such drug combinations have an increased risk of heart attack within 48 hours of taking them.

There's also increased risk of priapism (a hard-on that won't go down). This can cause permanent damage and loss of function. An erection lasting over four hours needs urgent medical attention.

With HIV medications

Some HIV drugs (such as protease inhibitors) raise levels of Viagra and other erection medication in the body, so caution and medical advice is recommended. Half the dose may be needed and not more than one dose taken in 48 hours, during which time use of poppers is not advisable.

With stimulants

Taking Viagra-type drugs with stimulants like cocaine, crystal meth or speed increases pressure on the heart and the risk of a heart attack.

The law

Viagra-type drugs can generally only be obtained legally in the UK with a prescription from your doctor. Possession of the drugs without a prescription is not illegal, but supplying it to others is controlled under the Medicines Act and there have been many prosecutions for selling these drugs illegally.

From February 2007, Viagra started being sold without prescription from a handful of Boots pharmacies in Manchester, ahead of this being introduced nationwide. The pills are to be sold in a pack of four costing around £50 and only to men between 30 and 65. Before buying men will have their blood pressure, cholesterol and glucose levels checked and must fill out a health questionnaire.

More information and support

Learn more about erection problems and their treatment in the Power room section of this website.