Erectile dysfunction (ED) is difficulty getting or keeping an erection. It affects about 30 million people in the United States¹, and nearly 40% of men experience some form of ED by age 40.² And yet, many men struggle to seek treatment. Below-the-belt issues, like problems in the bedroom, stand as one of the most rarely discussed topics among men with their doctors. We get it. It's not the easiest thing to talk about. But research shows that pressing pause on your sex life because you can't get or maintain an erection can lead to stress, self-confidence issues, and relationship problems. We're here to help. We're making it easier than ever to get ED medications discreetly, from the comfort of home. Now, you're just a few steps away from more confident sexual health.

Sildenafil is one of the most commonly prescribed medications to treat erectile dysfunction (ED). It belongs to a class of drugs known as PDE5 inhibitors, which block the PDE5 enzyme. This enzyme regulates blood flow in different parts of your body, including important erectile tissues. When PDE5 is active, these tissues constrict and reduce blood flow in your penis. Sildenafil relaxes these blood vessels, which helps you build and maintain an erection.

The information packet that comes with your prescription will have in-depth instructions on how to take sildenafil. Generally, you can take sildenafil with or without food about 1 hour before sexual activity. Sildenafil can be taken between 30 minutes to 4 hours before sexual activity if needed. Do not take sildenafil more than once daily.

When prescribed for erectile dysfunction, sildenafil is available in three dosages: 25 mg, 50 mg, and 100 mg. If you have no related health conditions and want to start using sildenafil to treat erectile dysfunction, the recommended or typical 'starter' dosage for men age 65 and under is 50 mg. For men over 65 years old, the recommended 'starter' dosage is 25 mg. Your clinician will ultimately determine whether you qualify for your prescription and dosage, if applicable.

Do not take sildenafil if you:
• take any medicines called nitrates, often prescribed for chest pain, or guanylate cyclase stimulators like Adempas (riociguat) for pulmonary hypertension. Your blood pressure could drop to an unsafe level.
• are allergic to sildenafil, as contained in Viagra and Revatio, or any of the ingredients in Viagra

Discuss your health with your healthcare provider to ensure that you are healthy enough for sex. If you experience chest pain, dizziness, or nausea during sex, seek immediate medical help.

Sildenafil can cause serious side effects. Rarely reported side effects include:
• an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, get medical help right away. If it is not treated right away, priapism can permanently damage your penis.
• sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). Stop taking sildenafil and call your healthcare provider right away if you have any sudden vision loss.
• sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness. If you have these symptoms, stop taking sildenafil and contact a doctor right away.

Before you take sildenafil, tell your healthcare provider if you:
• have or have had heart problems such as a heart attack, irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure
• have had heart surgery within the last 6 months
• have pulmonary hypertension
• have had a stroke
• have low blood pressure, or high blood pressure that is not controlled
• have a deformed penis shape
• have had an erection that lasted for more than 4 hours
• have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia
• have retinitis pigmentosa, a rare genetic (runs in families) eye disease
• have ever had severe vision loss, including an eye problem called NAION
• have bleeding problems
• have or have had stomach ulcers
• have liver problems
• have kidney problems or are having kidney dialysis
• have any other medical conditions

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Sildenafil may affect the way other medicines work, and other medicines may affect the way sildenafil works, causing side effects. Especially tell your healthcare provider if you take any of the following:
• medicines called nitrates
• medicines called guanylate cyclase stimulators such as Adempas (riociguat)
• medicines called alpha-blockers, such as Hytrin (terazosin HCl), Flomax (tamsulosin HCl), Cardura (doxazosin mesylate), Minipress (prazosin HCl), Uroxatral (alfuzosin HCl), Jalyn (dutasteride and tamsulosin HCl), or Rapaflo (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of Viagra with alpha-blockers can lead to a drop in blood pressure or to fainting
• medicines called HIV protease inhibitors, such as ritonavir (Norvir), indinavir sulfate (Crixivan), saquinavir (Fortovase or Invirase), or atazanavir sulfate (Reyataz)
• some types of oral antifungal medicines, such as ketoconazole (Nizoral) and itraconazole (Sporanox)
• some types of antibiotics, such as clarithromycin (Biaxin), telithromycin (Ketek), or erythromycin
• other medicines that treat high blood pressure
• other medicines or treatments for ED
• SILDENAFIL contains sildenafil, which is the same medicine found in other drugs like Viagra and Revatio. Revatio is used to treat a rare disease called pulmonary arterial hypertension (PAH). Viagra is used to treat erectile dysfunction. Sildenafil should not be used with Viagra or Revatio or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Adcirca [tadalafil])

Sildenafil does not protect against sexually transmitted diseases, including HIV.

The most common side effects of sildenafil: headache; flushing; upset stomach; abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision; stuffy or runny nose; back pain; muscle pain; nausea; dizziness; rash.

INDICATION
Sildenafil is prescription medicine used to treat erectile dysfunction (ED). Sildenafil is not for women or children.

For a full list of side effects, interactions, and contraindications, please visit medlineplus.gov.

Prescription medications are not currently available in the following states: Alabama, Delaware, District of Columbia, Idaho, Kansas, Kentucky, Louisiana, Mississippi, New Mexico, and West Virginia. This list is subject to change.